Key result
Peripheral ultrafiltration is linked to ~11 mL/min higher discharge GFR vs. conventional therapy.
Why the study?
Patients admitted for decompensated heart failure often require high doses of intravenous diuretics, and whether peripheral ultrafiltration improves hydric control, renal protection, and hospital stay compared with conventional treatment remained to be analyzed.
Does peripheral ultrafiltration improve renal function, increase diuresis, and reduce hospital stay in patients with acute heart failure and poor diuretic response compared to conventional diuretic escalation?
Cohort (n=56)
No
Does peripheral ultrafiltration improve renal function, increase diuresis, and reduce hospital stay in patients with acute heart failure and poor diuretic response compared to conventional diuretic escalation?
Peripheral ultrafiltration via peripheral venous access appears effective for improving decongestion, protecting renal function, and shortening hospital stay in diuretic-resistant acute heart failure.
Peripheral ultrafiltration was associated with better renal function and shorter stays in diuretic-resistant acute HF; hypothesis-generating and requires randomized confirmation.
AIMS: Patients with heart failure (HF) admitted for decompensation often require high doses of intravenous diuretics. This study aims to analyse whether the use of peripheral ultrafiltration (UF) in patients hospitalized for acute HF with systemic-predominant congestion results in better hydric control, renal protection, and reduction of hospital stay compared with conventional treatment. METHODS AND RESULTS: This study was a retrospective, comparative, single-centre study of 56 patients admitted for HF with systemic congestion with a poor diuretic response after diuretic escalation. One group underwent peripheral UF (35 patients) and others were maintained on intense diuretic treatment (control group, 21 patients). The diuretic response and days of hospital stay were compared between and within groups. The baseline characteristics of both groups were similar: males with right ventricular failure and renal dysfunction. The inter-group analysis showed that patients who received UF had better glomerular filtration rate (GFR; UF: 39.2 ± 18.2 vs. control: 28.7 ± 13.4 mL/min; P = 0.031) and higher diuresis (UF: 2184 ± 735 vs. control: 1335 ± 297 mL; P = 0.0001) at hospital discharge despite less need for diuretic drugs. Days of hospital stay were shorter in the UF group (UF: 11.7 ± 10.1 vs. control: 19.1 ± 14.4 days; P = 0.027). Intra-group analysis showed that patients receiving UF improved GFR, increased diuresis, and reduced weight at discharge (P < 0.001), whereas patients on conventional treatment only experienced improved weight but worsening renal function at discharge. CONCLUSIONS: In patients with acute HF with systemic congestion and diuretic resistance, UF compared with conventional treatment produces greater decongestion and renal protection, reduces the total diuretic load, and shortens the length of hospital stay.
No takes yet. Share an insight, caveat, or question.
López‐Vilella et al. (2023) conducted a cohort in Heart failure with systemic congestion and poor diuretic response (n=56). Peripheral ultrafiltration vs. Intense diuretic treatment was evaluated on Glomerular filtration rate at hospital discharge (p=0.031). Peripheral ultrafiltration improved glomerular filtration rate at discharge (39.2 vs 28.7 mL/min, p=0.031) and shortened hospital stay (11.7 vs 19.1 days, p=0.027) compared to conventional treatment.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: