The prolonged veno-venous hemofiltration in treatment of a hepatorenal syndrome in patients with chronic diffuse diseases of liver
Abstract
Aim of investigation. To study efficacy of prolonged veno-venous hemofiltration (PVVHF) in treatment of patients with liver cirrhosis (LC), complicated by hepatorenal syndrome (HRS) and resistant ascites.
Stuff and methods. Original study was carried out basing on 34 PVVHF procedures in 14 patients with HRS and ascites. Alcohol-induced LC was diagnosed in 7 cases, autoimmune cirrhosis – in 4 and viral etiology – in 4. Duration of PVVHF session was from 8 to 29 hs with an interval of 1,5–3 days according to gain in body weight of the patient, rate of diuresis and severity of uremia. This procedures was combined to paracentesis for patients with resistant ascites.
Results. PVVHF procedures resulted in significant decrease of serum urea and creatinine levels, restitution of hourly diuresis rate. Significant increase in contents of sodium in plasma from 131±5,3 to 140,6±3,8 meq/l and improvement of systemic and intrarenal hemodynamics was obtained. According to US data, signs of overhydration and free fluid in abdominal and pleural cavities considerably decreased. Increase in glomerular filtration rate allowed to decrease a dose of diuretic agents. Procedures were well tolerated by patients. Four of 14 persons (28,5%) were discharged from hospital with normal diuresis, in 6 (43%) the transplantation of liver with complete restoration of renal function in postoperative period was executed, 4 (28,5%) patients have died due to progressive multiorgan failure.
Conclusion. Addition of PVVHF to HRS complex therapy enables to improve quality of life, increase survival rate and to provide support during search for donor organ for transplantation.
About the Authors
I. V. AleksandrovaRussian Federation
Ye. I. Pervakova
Russian Federation
L. V. Donova
Russian Federation
V. V. Artamonov
Russian Federation
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Review
For citations:
Aleksandrova I.V., Pervakova Ye.I., Donova L.V., Artamonov V.V. The prolonged veno-venous hemofiltration in treatment of a hepatorenal syndrome in patients with chronic diffuse diseases of liver. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(4):38-42. (In Russ.)
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