Comparison of solute clearance and anticoagulant efficiency on extracorporeal circulation pathway in different modes of continuous renal replacement therapy

Objective To compare the effects of three modescontinuous veno venous hemofiltration (CVVH), continuous veno venous hemodialysis (CVVHD) and continuous veno venous hemofiltration (CVVHDF) of continuous renal replacement therapy (CRRT) on solute clearance and anticoagulant efficiency on extracorporeal circulation pathway.Methods A total of 49 patients who received CRRT in our hospital from March to October in 2017 were selected. They received CVVH, CVVHD and CVVHDF three modes respectively. The patients were given the same treatment dose, blood volume, anticoagulation way and dosage of anticoagulant. The clearance rate of creatinine, urea, uric acid, phosphorus and beta 2 microglobulin in three different treatment modes was compared. At the same time, the coagulations of the extracorporeal circulation pathway during the treatment were monitored.Results At the same therapeutic dose, the solute clearance rate of serum creatinine, urea, uric acid and phosphorus in CVVHDF and CVVHD was significantly higher than in CVVH (P<0.01). The solute clearance rate of beta 2 microglobulin in CVVHDF and CVVH was significantly higher than in CVVHD (P<0.01). Under the same anticoagulant method and the dosage of anticoagulant, the coagulations of the extracorporeal circulation in the CVVHDF mode were significantly superior to those in CVVH and CVVHD (P<0.05).Conclusions The clearance rate of CVVHDF and CVVHD for small solutes was higher than that of CVVH, while the clearance rates of CVVHDF and CVVH to macromolecules solutes were higher than those of CVVHD. Under the same anticoagulation way and the dosage of anticoagulants, the anticoagulant efficiency of CVVHDF on extracorporeal circulation was more satisfactory than CVVH and CVVHD. Therefore, it is suggested that CVVHDF may be the first choice in CRRT.