Diuretics or ultrafiltration in the treatment of acute decompensated heart failure: An updated systematic review and meta-analysis.

Abstract

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.

• Authors: Vasileios Terpos, Stefanos Roumeliotis, Panagiotis I Georgianos, Eleni Papa, Dimitrios G Tsalikakis, Evangelos Papachristou, Vassilios Liakopoulos
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) (Jul 19 2023) ISSN: 1744-9987 [Electronic] Australia
• PMID: 37469222 (Publication Type: Journal Article)
• Copyright: © 2023 International Society for Apheresis and Japanese Society for Apheresis.