Evaluation of the Tolerability and Efficacy of the Main Hemodialysis Techniques in Intensive Care

Abstract

Introduction : Acute renal failure in intensive care often necessitates extracorporeal renal replacement therapy. Intermittent hemodialysis (IHD) and continuous veno-venous hemofiltration (CVVH) are the two primary techniques employed, yet their relative efficacy and tolerability remain subjects of debate. This study compares these modalities in terms of hemodynamic stability, biological efficacy, and patient survival. Patients and Methods : This retrospective study, conducted in a multipurpose intensive care unit, included 51 adult patients who underwent either IHD or CVVH. Clinical, biological, and survival data were analyzed, and factors influencing outcomes were assessed using appropriate statistical methods. Results : CVVH, utilized in 69% of patients, demonstrated better biological stabilization, as indicated by significantly lower creatinine levels at discharge (p = 0.026). However, IHD was associated with a significantly higher survival rate (81% vs. 43%, p = 0.024). Patients receiving CVVH exhibited greater clinical severity. Conclusion : CVVH appears more suitable for hemodynamically unstable patients, whereas IHD, which is well tolerated, is associated with improved survival outcomes. The selection of renal replacement therapy should be individualized based on the patient’s clinical profile. Further prospective studies are warranted to validate these findings.