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Continuous Ultrafiltration in Acute Decompensated Heart Failure: Current Issues and Future Directions

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Abstract

Most patients hospitalized for acutely decompensated heart failure (ADHF) present with symptoms and signs of volume overload, which are also associated with high rates of death and re-hospitalization. Several studies have investigated the possible use of extracorporeal ultrafiltration in the management of ADHF, evaluating potential clinical benefits in terms of hospitalization and survival rates versus those of conventional diuretic therapy. Though ultrafiltration remains an extremely appealing therapeutic option for patients with AHDF, some of the most recent studies have reported conflicting results. Differences in the selection of study population, heterogeneity of the indications for the use of ultrafiltration, disparity in the ultrafiltration protocols, and high variability in the pharmacologic therapies used for the control group could explain some of these contradictory findings. The purpose of the present review is to provide an overview and an update on the mechanisms and clinical effects of ultrafiltration and on currently available evidence supporting its use in ADHF.

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Acknowledgments

No external funding was used in the preparation of this manuscript and none of the authors have any potential conflict of interest that might be relevant to the contents of this review.

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Authors and Affiliations

  1. Centro Cardiologico Monzino, I.R.C.C.S., Via Parea 4, 20138, Milan, Italy

    Giancarlo Marenzi, Marco Morpurgo & Piergiuseppe Agostoni

  2. Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Piergiuseppe Agostoni

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  1. Giancarlo Marenzi
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  2. Marco Morpurgo
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  3. Piergiuseppe Agostoni
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Correspondence to Giancarlo Marenzi.

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Marenzi, G., Morpurgo, M. & Agostoni, P. Continuous Ultrafiltration in Acute Decompensated Heart Failure: Current Issues and Future Directions. Am J Cardiovasc Drugs 15, 103–112 (2015). https://doi.org/10.1007/s40256-015-0107-6

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