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

Link to article at PubMed

Ther Apher Dial. 2023 Jul 19. doi: 10.1111/1744-9987.14037. Online ahead of print.


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.

PMID:37469222 | DOI:10.1111/1744-9987.14037

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