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Azotemia control provided by blood pump-assisted continuous hemofiltration has not been rigorously compared with that provided by intermittent hemodialysis (IHD) for critically ill patients with acute renal failure (ARF). The metabolic control achieved by continuous venovenous hemofiltration (CVVH) and IHD was compared. In ARF patients treated with CVVH (N= 11), the normalized daily dose of therapy was 0.59+/-0.23 (mean+/-SD) and the normalized protein catabolic rate was 1.82+/-0.95 g/kg per day. The serum urea nitrogen concentration (SUN) declined with CVVH from an initial value of 114+/-32 to 79+/-17 mg/dL at steady state (SUNs). The initial analysis was a theoretical comparison between CVVH azotemia control and the control that would have been provided by IHD. Simulated IHD data were generated by conventional urea kinetic methods. The peak concentration hypothesis was invoked to compare …