Why the study?
Diuretics remain the mainstay for volume overload in ADHF but can cause neurohormonal activation and worsening renal function, prompting interest in alternative strategies such as ultrafiltration.
This review highlights the clinical data and challenges associated with both traditional diuretic therapy and emerging ultrafiltration strategies for managing volume overload in acute decompensated heart failure.
Diuretics remain vital for ADHF volume overload despite RAAS stimulation; leaves open optimal adjunctive strategies in practice.
The epithet of acute decompensated heart failure (ADHF) is volume overload. ADHF is associated with a rising number of hospital admission for volume overload. Medication non-compliance, excessive salt intake, comorbidities, and/or disease progression can attribute to volume overload. Heart failure (HF) therapy has innovated during the past few decades, but diuretics have been the mainstay of treatment. Diuretics are vital even though these drugs stimulate the renin-angiotensin-aldosterone system (RAAS) and lead to adaptive responses like diuretic resistance, neurohormonal activation, and worsening renal function that may be inimical. There has been a thriving interest in cutting-edge strategies to manage volume overload in ADHF. The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) guidelines advocate pharmacological and non-pharmacological interventions to treat volume overload in ADHF patients. Ultrafiltration (UF) is, therefore, an emerging stand-in therapy of interest for treating volume overload in ADHF patients. This review article epitomizes available clinical data on the use of diuretics and UF in ADHF patients and identifies challenges for each approach.
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Zafar et al. (2020) studied this question.
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