Vasileios Terpos, Stefanos Roumeliotis, Panagiotis I. Georgianos, Eleni Papa, Dimitrios G. Tsalikakis, Evangelos Papachristou, Vassilios Liakopoulos

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

  • Nephrology
  • Hematology
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AbstractIntroductionHospitalization for decompensated heart failure is a major public health issue.MethodsWe 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.ResultsCompared 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.ConclusionAmong patients with decompensated heart failure, compared to diuretics, ultrafiltration is associated with reduced rehospitalizations and increased weight/net fluid loss.

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