Hemofiltration or hemodialysis for acute kidney injury?
Department of Nephrology and Medical Intensive Care, Charité University Hospital Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
Critical Care 2012, 16:147 doi:10.1186/cc11450
See related research by Friedrich et al., http://www.ccforum.com/content/16/4/R146Published: 10 August 2012
The optimal choice of modality for acute renal replacement therapy is unclear at present. Diffusive therapy (hemodialysis) removes small solutes mainly, whereas convective therapies (hemofiltration and hemodiafiltration) may also eliminate larger molecules such as myoglobin or cytokines. Conversely, convective therapies might predispose patients to filter clotting and thus increased costs. A systematic review and meta-analysis of clinical trials could not find evidence for clinical benefits of either modality. Thus, the decision on renal replacement therapy modality still is based on the clinical status of the individual patient, the expertise of the medical and nursing staff, and local circumstances and availability.