Key result
Ultrafiltration treatment led to progressive clinical improvement in a 70-year-old man with acute heart failure, worsening renal function, and diuretic resistance.
Case Report (n=1)
Ultrafiltration may provide clinical improvement in patients with acute heart failure and cardiorenal syndrome who are resistant to diuretic treatment.
May support ultrafiltration in select diuretic-resistant acute HF with cardiorenal syndrome; hypothesis-generating, requires randomized confirmation.
Cardio-Renal Syndrome (CRS) is a renal dysfunction occurring in a large percentage of pts hospitalised for congestive heart failure (CHF). It is characterised by an excessive fluid retention inside the body, resistance to conventional medical therapy, worsening renal function (WRF) and higher mortality. The prevalence of CRS is likely increased because of the improved survival of HF patients. WRF occurs frequently among hospitalised HFF and is associated with a significantly worse outcome. Clinical features at admission can be used to identify patients at high risk for developing WRF. The clinical case presented concerns a 70-year-old diabetic man with post-ischemic cardiomyopathy and chronic kidney failure, admitted to our division for acute heart failure. During hospitalisation he showed a progressive WRF and resistance to diuretic treatment. After Ultrafiltration treatment there was a progressive clinical improvement. Many treatments have been investigated in order to improve renal function, but none has been demonstrated to improve clinical outcome. Currently Ultrafiltration is reserved to patients with volume overload when traditional medical therapies fail and/or patients become resistant to diuretics.
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Zilioli et al. (2011) conducted a case report in Acute heart failure and cardiorenal syndrome (n=1). Ultrafiltration was evaluated on Clinical improvement. Ultrafiltration treatment led to progressive clinical improvement in a 70-year-old man with acute heart failure, worsening renal function, and diuretic resistance.
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