On short-term dialysis

Abstract

The short-term dialysis occupies a medium position between the obligatory dialysis in patients with acute renal failure and the intermittent chronic dialysis in patients with irreversible renal diseases.By short-term dialysis many, eventually fatal, therapeutic errors may be avoided. In many cases, it is possible to gain time necessary for further diagnostic considerations in azotaemia of obscure origin, for overcoming the critical moments of exacerbation in chronic nephropathies and for obtaining a remission of variable duration. Thanks to the short-term dialysis, the condition of the patients in the preoperative period could be controlled, the surgical hazards reduced and the operative results improved. The performance of several dialyses permits a better selection of patients for chronic dialysis and renal transplantation and the avoidance of useless efforts to submit inappropriate patients to such a mode of treatment.At present haemodialysis and peritoneal dialysis belong to the most promising methods in the treatment of renal failure [1,2,3,6,7,10,12,14]. Depending on the character and phase of renal diseases and the available facilities, several types of dialysis have been developed, which differ by their technic, number and duration of the separate procedures, etc. [5,8]. The following types of dialysis have gained a relatively wide acceptance [14]:1. Obligatory dialysis, used mainly in cases of acute renal failure, intoxications with dialyzable poisons and in conditions of acute hyperhydration.2. Long-term dialysis [9]. 3. Prophylactic dialysis, for prevention of severe azotaemia and dyselectrolythemia [16].4. Intermittent, chronic dialysis in patients with chronic and irreversible renal lesions in end-stage renal failure.Besides these four "classic" types of dialysis, the indications, advantages and imperfections of which are more or less established, there is also a fifth type, the so-called "short-term" dialysis. This type of dialysis occupies a medium place between the obligatory dialysis in cases of acute renal failure and the relatively indicated chronic dialysis. A certain variant of the short-term dialysis is the socalled "dialysis in unselected patients" [5].The indications of short-term dialysis are not completely elucidated: the technique, duration and tactics of this type of dialysis, the number of procedures Urology and Nephrology 1, 1969