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No Difference Found in Treatments for Acute Kidney Failure
Date:2/19/2008

t is actually contributing," he said. "The more complex it gets, the harder it is to randomize patients into a study. Depending on what the patients suffer from, the outcomes are quite variable."

The incidence of acute kidney failure appears to be increasing, the report said, although exact numbers are lacking. Recent studies have indicated that chronic kidney disease is on the rise in the United States, with the increased linked to obesity, diabetes and high blood pressure. One report last year said the prevalence of chronic kidney disease had risen in a decade from 10 percent to 13 percent of the U.S. population.

Someone with chronic kidney disease can be kept alive for years, by dialysis and perhaps a kidney transplant. The outlook is much grimmer in many cases of acute kidney failure because of the medical problems that led the kidneys to suddenly stop working, Swartz said.

"We looked at all the patients we treated and tried to account for as many of these kinds of factors for which we could get data," he said. "We found it extremely difficult, and most of my colleagues would tell you the same thing."

There has been a belief that continuous dialysis might be better overall, especially for sicker patients, said Dr. Mitchell H. Rosner, an assistant professor of internal medicine at the University of Virginia. "It keeps blood pressure low and is slower and more gentle," he said. "But the data are showing more and more that, despite the theoretical advantages, when CRRT is put to the test, it doesn't perform as expected."

However, CRRT might still be preferable in some cases, Rosner said. "It sometimes is just not practicable to give intermittent dialysis," he said. "It requires more nursing and more effort. Continuous dialysis is simpler to do."

The decision can also be influenced by the capabilities of individual centers, Swartz added. "It depends on the expertise in doing a particular kind of treatment,"
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