Slow continuous hemodialysis —New Therapy for Acute Renal Failure in Critically Ill Patients—: I. Theoretical Consideration and New Technique

Abstract

In order to treat acutely uremic patients in an unstable hemodynamic state, we developed a new system for slow continuous hemodialysis. It is well known that continuous hemofiltration or peritoneal dialysis are successful in terms of removing the excess body water without adverse effects on hemodynamics. On the other hand, hemodialysis is far more effective in eliminating solutes such as uremic toxins, especially under a catabolic state. In order to combine the merits of both interventions, volume control and solute removal were dealt with separately in our system. The main system is composed of a double-pump driven closed circuit for the re-circulated hemodialysis. Volume control was achieved accurately within ±5% error of the set rate. The dialysance was evaluated in vitro and the efficacy of solute elimination was simulated mathematically. It was speculated that slow continuous hemodialysis could be a new method of treating critically ill patients with acute renal failure. © 1988, The Japanese Circulation Society. All rights reserved.