Comparison of Outcomes From Intermittent Hemodialysis and Continuous Renal Replacement Therapy With Systemic or Regional Anticoagulation in 128 Patients in a Polish Intensive Care Unit

BACKGROUND This retrospective study of 128 patients admitted to an intensive care unit (ICU) who required renal replacement therapy (RRT) aimed to compare outcomes from 3 treatment approaches: intermittent hemodialysis (IHD), continuous renal replacement therapy (CRRT) with heparin, and CRRT with citrate anticoagulation. MATERIAL AND METHODS We analyzed data from 128 medical histories of patients treated in the Department of Anesthesiology and Intensive Care of the Regional Specialist Hospital (RSH) in Olsztyn between January 2003 and December 2011. Depending on the type of renal replacement therapy and anticoagulation used, the patients were assigned to one of the 3 cohorts: cohort I - 41 patients receiving IHD (IHD), cohort II - 40 patients receiving CRRT with heparin anticoagulation (unfractionated and low-molecular-weight heparin) (HEP), and cohort III - 47 patients receiving CRRT with citrate anticoagulation (CITR). RESULTS No statistically significant differences were found in ICU, 90-day, in-hospital, and long-term mortality (ie, at the end of the observation period [31/12/2020]), between IHD, HEP, and CITR cohorts (P=0.744, P=0.763, P=0.833, P=0.958, respectively). Patients in the IHD cohort were significantly more likely to be dependent on long-term dialysis treatment than all the other patients combined after discharge from the hospital (P=0.001). CONCLUSIONS The renal replacement modality and the type of anticoagulation did not affect mortality. However, IHD was associated with a higher percentage of long-term dialysis-dependent patients after hospital discharge.