To asses whether continuous arteriovenous ultrafiltration (CAVU) might constitute a useful alternative to hemodialysis in the management of patients with advanced liver failure, we carried out CAVU in 3 patients with decompensated Laennec's cirrhosis. CAVU was utilized in two patients with acute renal failure and pulmonary edema to stabilize renal function and facilitate administration of large amounts of fluid. In the third case, CAVU was successfully utilized to mobilize fluid in a patient refractory to conventional diuretic regimens. We conclude that CAVU may constitute an appropriate alternative to traditional hemodialysis in patients with advanced liver disease and renal functional impairment.
PerezG.O., OsterJ.R.: A critical review of the role of dialysis in the treatment of liver disease.The Kidney in Liver Disease (M. Epstein, ed) (1978) p 325–336.
2.
ParsonsV., WilkinsonS., WestonS.: Use of dialysis in the treatment of renal failure in liver disease.Postgrad. Med. J. (1975) 51: 512–520.
3.
EpsteinM.: Hepatorenal syndrome, In, Bockus Gastroenterology, 4th edition, edited by BerkJ.E., Saunders, Philadelphia, pp (1985) 3138–3149.
4.
EpsteinM.: Hepatorenal syndrome. In: Current Therapy in Nephrology and Hypertension (1984-1985), ed. by GlassockR.J.. B.C. Decker, Inc., Burlington, Ontario, 1984, pp. 249–251.
5.
The Kidney in Liver Disease, 2nd ed, ed EpsteinM., New York, Elsevier Biomedical, (1983).
6.
EpsteinM., LeppB.A., HoffmanD.S., and LevisonR.: Potentiation of furosemide by metolazone in refractory edema. Curr. Ther.Res1977; 21: 656–667.
