Does ultrafiltration improve preservation of renal function at 96 hours compared to a stepped pharmacologic-therapy algorithm in patients hospitalized for acute decompensated heart failure, worsened renal function, and persistent congestion?
In patients with acute decompensated heart failure and cardiorenal syndrome, stepped pharmacologic therapy is superior to ultrafiltration for preserving renal function and is associated with fewer adverse events.
In a randomized trial involving patients hospitalized for acute decompensated heart failure, worsened renal function, and persistent congestion, the use of a stepped pharmacologic-therapy algorithm was superior to a strategy of ultrafiltration for the preservation of renal function at 96 hours, with a similar amount of weight loss with the two approaches. Ultrafiltration was associated with a higher rate of adverse events. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT00608491.).
“Ultrafiltration, as administered in this study, had higher rates of adverse events, and therefore offers no advantage to stepped pharmacologic care in patients with acute decompensated HF, worsened renal function and persistent congestion.”
Bart et al. (Tue,) studied this question.
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