Key result
Ultrafiltration significantly reduced heart failure hospitalizations compared to diuretics in patients with decompensated heart failure (RR 0.72; 95% CI 0.55-0.96; p=0.02).
Why the study?
Hospitalization for decompensated heart failure is a major public health issue, leaving open whether ultrafiltration provides a benefit over diuretics in reducing mortality or readmissions.
Does ultrafiltration reduce mortality or hospital readmissions in patients with acute decompensated heart failure compared to diuretics?
Meta-Analysis (n=941)
Does ultrafiltration reduce mortality or hospital readmissions in patients with acute decompensated heart failure compared to diuretics?
In patients with acute decompensated heart failure, ultrafiltration reduces heart failure rehospitalizations and increases fluid loss compared to diuretics, though it does not significantly impact mortality.
Answers are grounded in this paper and cite their sources.
May favor ultrafiltration over diuretics to reduce HF hospitalizations in decompensated HF; confirms benefit in meta-analysis of trials.
INTRODUCTION: Hospitalization for decompensated heart failure is a major public health issue. METHODS: We performed a meta-analysis to summarize and analyze if there is a benefit in using ultrafiltration over diuretics in terms of reducing mortality or hospital readmissions, primarily and identified 10 randomized controlled trials (RCTs) including 941 patients. RESULTS: Compared to diuretics, treatment with ultrafiltration was associated with a significant reduction in heart failure hospitalizations (risk ratio [RR]: 0.72; 95% confidence interval [CI]: 0.55-0.96, p = 0.02) and significant increase in weight and net fluid loss (mean difference [MD]: -1.55, CI: -2.36 to -0.74, p = 0.0002) and (MD: -2.10, CI: -3.32 to -0.89, p = 0.0007), respectively. There was no significant difference among treatments regarding the duration of hospitalization, the increase in serum creatinine levels, and mortality. CONCLUSION: Among patients with decompensated heart failure, compared to diuretics, ultrafiltration is associated with reduced rehospitalizations and increased weight/net fluid loss.
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Terpos et al. (2023) conducted a meta-analysis in acute decompensated heart failure (n=941). Ultrafiltration vs. Diuretics was evaluated on heart failure hospitalizations (RR 0.72, 95% CI 0.55-0.96, p=0.02). Ultrafiltration significantly reduced heart failure hospitalizations compared to diuretics in patients with decompensated heart failure (RR 0.72; 95% CI 0.55-0.96; p=0.02).
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