Key result
Ultrafiltration increases short-term BUN by ~4 mg/dL vs diuretics, without affecting other prognostic biomarkers.
Why the study?
Does ultrafiltration improve prognostic cardiac and renal biomarkers compared to diuretics in patients with acute decompensated heart failure?
Population
Patients with acute decompensated heart failure across 10 randomised trials
Comparison
Ultrafiltration vs diuretics
Design
Systematic review and inverse-variance random-effects meta-analysis of randomised controlled trials
Authors
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No short-term biomarker superiority for ultrafiltration over diuretics in acute decompensated heart failure; reinforces comparable renal effects aside from greater BUN rise.
Meta-Analysis
Does ultrafiltration improve prognostic cardiac and renal biomarkers compared to diuretics in patients with acute decompensated heart failure?
Mean Difference: 3.88 (95% CI 0.59–7.17)
Ultrafiltration has a similar impact on prognostic cardiac and renal biomarkers compared to diuretic therapy in acute decompensated heart failure, with the exception of a greater increase in short-term blood urea nitrogen.
Tay et al. (2023) conducted a meta-analysis in Acute decompensated heart failure. Ultrafiltration vs. Diuretics was evaluated on Cardiac (BNP, NT-proBNP) and renal biomarkers (serum creatinine, serum sodium, and blood urea nitrogen) (MD 3.88, 95% CI 0.59-7.17). Ultrafiltration produced greater increases in short-term blood urea nitrogen compared to diuretics (MD 3.88 mg/dL; 95% CI 0.59-7.17), with no significant difference in other prognostic biomarkers.
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