No Difference Found in Treatments for Acute Kidn...( Continuous vs. intermittent dialysis ...),Health

Date:2/19/2008

Continuous vs. intermittent dialysis produced same results, analysis shows

TUESDAY, Feb. 19 (HealthDay News) -- Studies show no particular advantage to any single treatment for acute renal failure, the sudden collapse of kidney function that carries with it a high risk of death, Canadian researchers report.

An analysis of 38 trials found no difference in the death rates, which are usually higher than 30 percent, for one method or another, according to a report in the Feb. 20 issue of the Journal of the American Medical Association.

Methods used in the various trials were continuous renal replacement therapy (CRRT), in which the person whose kidneys have failed gets continuous dialysis, a machine treatment that removes impurities from the blood, and intermittent hemodialysis, in which the purifying treatment is not continuous.

"There doesn't seem to be any difference in any measurable outcome that has been evaluated in trials," said study author Dr. Neesh Pannu, an assistant professor of pathology and critical care medicine at the University of Alberta, in Edmonton. "We were not able to identify any subgroup that might have any benefit from one method over the other."

But that can't be said with certainty because most of the trials were small, Pannu added. "There has been a relatively small number of patients, so it is hard to look at any subgroups," she said.

"This is a very difficult area, and it's hard to study it," said Dr. Richard Swartz, a professor of internal medicine at the University of Michigan and leader of one of the studies included in the analysis. "Acute kidney failure usually is a consequence of bad things happening to people. You have to look at what brought you to kidney failure -- heart disease, lung disease, systemic infections, all of those things contribute to mortality."

"Unless you can account for these comorbidities, you can't account for what a treatmen
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