Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Wong, CW, Rushton, CA, Ahmed, F, Cunnington, C, Davies, S ORCID: https://orcid.org/0000-0001-5127-4755, Patwala, A, Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 and Satchithananda, D (2016) Ultrafiltration for acute decompensated cardiac failure: A systematic review and meta-analysis. International Journal of Cardiology, 228. pp. 122-128.

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Abstract

Background
Ultrafiltration is a method used to achieve diuresis in acute decompensated heart failure (ADHF) when there is diuretic resistance, but its efficacy in other settings is unclear. We therefore conducted a systematic review and meta-analysis to evaluate the use of ultrafiltration in ADHF.

Methods
We searched MEDLINE and EMBASE for studies that evaluated outcomes following filtration compared to diuretic therapy in ADHF. The outcomes of interest were body weight change, change in renal function, length of stay, frequency of rehospitalization, mortality and dependence on dialysis. We performed random effects meta-analyses to pool studies that evaluated the desired outcomes and assessed statistical heterogeneity using the I2 statistic.

Results
A total of 10 trials with 857 participants (mean age 68 years, 71% male) compared filtration to usual diuretic care in ADHF. Nine studies evaluated weight change following filtration and the pooled results suggest a decline in mean body weight − 1.8; 95% CI, − 4.68 to 0.97 kg. Pooled results showed no difference between the filtration and diuretic group in change in creatinine or estimated glomerular filtration rate. The pooled results suggest longer hospital stay with filtration (mean difference, 3.70; 95% CI, − 3.39 to 10.80 days) and a reduction in heart failure hospitalization (RR, 0.71; 95% CI, 0.51–1.00) and all-cause rehospitalization (RR, 0.89; 95% CI, 0.43–1.86) compared to the diuretic group. Filtration was associated with a non-significant greater risk of death compared to diuretic use (RR, 1.08; 95% CI, 0.77–1.52).

Item Type: Article
Additional Information: This work is made available online in accordance with publisher policies
Uncontrolled Keywords: heart failure; meta-analysis; systematic review; ultrafiltration; diuretics
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 09 Nov 2016 09:51
Last Modified: 05 Apr 2019 09:03
URI: http://eprints.keele.ac.uk/id/eprint/2451

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