The Elimination of Low-Molecular-Weight Proteins in Patients with Isolated Acute Renal Failure

Abstract

Objective: to study the effectiveness of some types of semipermeable dialysis membranes and replacement therapy techniques in patients with isolated acute renal failure (iARF). Subjects and methods: Eighty-nine patients aged 24 to 67 years, who received intensive and replacement/maintenance therapy, were examined. The patients were divided into 3 groups in accordance with their condition rated by the APACHE III scale, from the used dialysis membranes and renal replacement/maintenance therapy options. Results. By varying the permeability of a membrane, its area and the volume of convection, we can control the rate of substance elimination, which is similar to that of test markers having a molecular weight of 100 to 15000 Da. Conclusion. Adequate replacement therapy for iARF is possible only when high-flux, high-permeability dia-lyzers are applied. The indices of hemodialysis/hemodiafiltration adequacy in terms of urea cannot be determinants in patients with iARF. The achievement of elimination of low-molecular-weight proteins — markers of uremic intoxication to 30—35% and/or an increase in effective albumin concentrations as a summary marker of toxicity by 16—20% is of much more importance. Key words: isolated acute renal failure, uremic toxins, hemodialysis, hemodiafiltration.