Summary
In our experience hemodialysis proved to be unsatisfactory in the treatment of acute
renal failure after cardiovascular surgical intervention because of its negative influence
on the often critical hemodynamic situation of the patients.
In 21 cases we performed a continuous peritoneal dialysis (CPD) for 1 to 29 (mean
9.2) days by using a Tenckhoff catheter (16). Treatment was started when anuria occurred or when serum nonprotein
nitrogen increased. Satisfactory volume equilibration was established by this treatment.
A pathological increase of serum electrolytes could be prevented; serum potassium,
in particular, did not exceed 5.6 mVal/l. No dysfunctions in acid-base balance occurred.
The serum levels of nonprotein nitrogen decreased: Serum carbamid was diminished from
229 ± 14mg% to 160 ± 10 mg% and serum creatinine from 7.7 ± 0.6 mg% to 6.0 ± 0.8 mg%
(p < 0.05). Disturbances of hemodynamic and respiratory functions could be avoided
by CPD. Peritoneal reactions were noted in 5 cases.
In our opinion continuous peritoneal dialysis seems to be a suitable alternative to
hemodialysis in the treatment of acute renal failure after open heart surgery.
Key words
Acute renal failure - Cardiac surgery - Cardio-pulmonary bypass - Continuous peritoneal
dialysis
