[Renal replacement therapies in acute kidney failure]
Mengarelli C, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A.
Record ID 32018001567
Spanish
Original Title:
Terapias de reemplazo renal en insuficiencia renal aguda
Authors' recommendations:
Moderate-quality evidence suggests that continuous renal replacement therapies when compared with intermittent renal replacement therapies are clinically similar in adult patients with acute kidney failure. They do not differ in global in-hospital mortality, in mortality at the Intensive Care Units or in the number of patients who survive with no need for subsequent kidney replacement. Also, they did not show differences in improvement of hemodynamic instability or episodes of low blood pressure. Continuous therapies showed higher risk for mild adverse events (coagulation of the filters used to carry out procedures, thrombocytopenia). No studies comparing the different continuous therapies have been found.
Clinical practice guidelines from Argentina, the United States and Europe surveyed recommend that the type of renal replacement should be based on the patient’s clinical condition, the medical and nursing staff expertise, the availability of the means required at the institution as well as local and social security regulations. Every patient with acute kidney failure should receive dialysis with equipment fitted with ultrafiltration. Continuous and intermittent therapies are supplementary and one does not exclude the other. The different consensuses of experts suggest the use of continuous therapies in patients with hemodynamic instability and/or brain edema, persistent metabolic acidosis or need for profuse negative fluid balance.
Given the cost heterogeneity of the different modalities and versions, the economic impact and the potential cost-effectiveness of continuous renal replacement therapies may vary.
Details
Project Status:
Completed
Year Published:
2020
URL for published report:
https://www.iecs.org.ar/home-ets/
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Acute Kidney Injury
- Renal Replacement Therapy
- Continuous Renal Replacement Therapy
- Intermittent Renal Replacement Therapy
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.