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- W2014602291 abstract "enough time to observe any potential changes in their Background Effective management of congestion through ultrafiltration has become an area of extreme interest in patients with acute decompensated heart failure (ADHF) especially after the advent of the portable ultrafiltration devices. Several studies have so far explored the role of ultrafiltration in this setting, and the CARRESS-HF trial represents the most recent effort in this field. The results of this long-awaited study were released during the 2012 American Heart Association scientific sessions and were simultaneously published. This landmark trial adds substantially to our knowledge on the use of ultrafiltration for ADHF while also raising a number of important questions. In this randomized controlled trial, ultrafiltration was compared with a diuretic-based stepped pharmacologic therapy (SPT) in patients admitted for ADHF only after they experienced worsening renal function (WRF). Although the trial was initially designed to include 200 participants, enrollment ended after recruitment of 188 patients due to a lack of evidence of benefit for ultrafiltration as well as an excess of adverse events in this group. Ultrafiltration was found to be inferior to SPT with regard to its impact on renal function and development of serious adverse events. Previously, UNLOAD trial had addressed several important questions about the role of ultrafiltration in ADHF. In that study, ultrafiltration was found to be superior to conventional diuretic therapy with regard to a number of end points such as weight loss and reduction in the rate of rehospitalization, while having no significant adverse impact on renal function. Indeed, a substudy of UNLOAD trial later confirmed that the unfavorable effects of ultrafiltration on the kidney are comparable with diuretics when renal function is precisely measured through using iothalamate rather than estimation by serum creatinine level. Worsening renal function was not a requirement for inclusion in the UNLOAD study; indeed, the participants were randomized “early” (ie, within 24 hours of admission) when there was not" @default.
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- W2014602291 date "2013-11-01" @default.
- W2014602291 modified "2023-10-16" @default.
- W2014602291 title "Ultrafiltration therapy for acute decompensated heart failure: Lessons learned from 2 major trials" @default.
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- W2014602291 doi "https://doi.org/10.1016/j.ahj.2013.08.009" @default.
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