No Difference Found in Treatments for Acute Kidney Failure

By Ed Edelson
HealthDay Reporter
Tuesday, February 19, 2008; 5:00 PM

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TUESDAY, Feb. 19 (HealthDay News) -- Studies show no particular advantage to any single treatment for acute renal failure, the sudden collapse of kidney function that carries with it a high risk of death, Canadian researchers report.

An analysis of 38 trials found no difference in the death rates, which are usually higher than 30 percent, for one method or another, according to a report in the Feb. 20 issue of the Journal of the American Medical Association.

Methods used in the various trials were continuous renal replacement therapy (CRRT), in which the person whose kidneys have failed gets continuous dialysis, a machine treatment that removes impurities from the blood, and intermittent hemodialysis, in which the purifying treatment is not continuous.

"There doesn't seem to be any difference in any measurable outcome that has been evaluated in trials," said study author Dr. Neesh Pannu, an assistant professor of pathology and critical care medicine at the University of Alberta, in Edmonton. "We were not able to identify any subgroup that might have any benefit from one method over the other."

But that can't be said with certainty because most of the trials were small, Pannu added. "There has been a relatively small number of patients, so it is hard to look at any subgroups," she said.

"Unless you can account for these comorbidities, you can't account for what a treatment is actually contributing," he said. "The more complex it gets, the harder it is to randomize patients into a study. Depending on what the patients suffer from, the outcomes are quite variable."

The incidence of acute kidney failure appears to be increasing, the report said, although exact numbers are lacking. Recent studies have indicated that chronic kidney disease is on the rise in the United States, with the increased linked to obesity, diabetes and high blood pressure. One report last year said the prevalence of chronic kidney disease had risen in a decade from 10 percent to 13 percent of the U.S. population.