Issn Print: 1058-2916

Publication Date: 2001/03/01


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Extended Daily Dialysis (EDD) rapidly reduces serum phosphate levels in Intensive Care Unit (ICU) Patients with Acute Renal Failure (ARF)

Victoria A. Kumar; Jane Y. Yeun; Julie T. Vu; Thomas A. Depner

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Excerpt

EDD is an effective method of renal replacement therapy for ICU patients with ARF. Using this novel modality, patients are dialyzed 6 days/week for 8 hours at a blood flow rate of 200 and a dialysate flow rate of 300 ml/min. A Nephrology nurse sets up the system and monitors 1–3 patients simultaneously.
Hyperphosphatemia is a common complication of both acute and chronic renal failure that is not adequately controlled by intermittent hemodialysis performed thrice weekly and usually requires oral phosphate binders. Between February 1997 and April 1999, 28 ICU patients with ARF received EDD for 3 or more consecutive days at the University of California Davis Medical Center. Data collected from 23 patients included serum phosphate levels prior (within 12 hours) to initial EDD and after each of the first 4 daily treatments. Results are listed below.
It should be noted that most patients included in this study received either total parenteral nutrition or enteral feeding. Within 4 days of initiation of EDD, serum phosphate levels were significantly reduced and in many cases, required supplementation. We recommend that serum phosphate levels be monitored daily after initiation of EDD to avoid severe hypophosphatemia. For ease of treatment, phospho-soda can be added directly to the bicarbonate concentrate of the dialysate.
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