Slow continuous hemodialysis--new therapy for acute renal failure in critically ill patients--Part 2. Animal experiments and clinical implication.

Five acutely uremic dogs were treated for 9 hours by means of slow continuous hemodialysis using our newly developed machine. The blood concentrations of urea nitrogen (BUN) and creatinine were determined every hour and were compared to those calculated from a mathematical pool model. In order to assess the accuracy of volume control, the body weight of dogs was monitored continuously by scale bed, under simultaneous 200 ml/hour infusion and ultrafiltration. Arterial and swan-ganz catheter were inserted to measure hemodynamic changes during hemodialysis. The efficacy of solute elimination was coincidental with the predicted value. The error of volume control was within +/- 5% of set rate. Hemodynamic parameters were not significantly influenced in spite of a large amount of volume exchange. In conclusion, it was demonstrated that slow continuous hemodialysis could be a better alternative to peritoneal dialysis, continuous hemofiltration or conventional hemodialysis in order to treat acute renal failure in critically ill patients, in terms of solute removal, volume control and the effects on hemodynamics.