Enhanced Sodium Extraction with Ultrafiltration Compared to Intravenous Diuretics

Ali, Syed Salman; Olinger, Chad C.; Sobotka, Paul; Bernard, Steven; Dahle, Thom G.; Bunte, Matthew C.; Blake, Donnevan; Campbell, Scott; Boyle, Andrew

doi:10.1016/j.cardfail.2006.06.393

Cited by 15 publications

(11 citation statements)

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“…Likewise, the ability to precisely control the removal of sodium and water allows the ultrafiltrate extracted from serum during UF therapy to be isotonic and isonatric. As such, UF results in a more effective reduction in total body sodium content when compared to an equal volume of fluid removed from the body by diuretic therapy [21,22] . Moreover, because solutes are free to cross the semipermeable membrane, large volumes of fluids can be removed without adversely affecting the concentration of solutes or serum electrolytes.…”

Section: Uf Versus Diuretic Therapymentioning

confidence: 99%

“…Moreover, because solutes are free to cross the semipermeable membrane, large volumes of fluids can be removed without adversely affecting the concentration of solutes or serum electrolytes. In contrast, diuretic therapy is associ-ated with potassium and magnesium loss; electrolyte abnormalities may predispose an already dysfunctional myocardium to malignant arrhythmias [22] .…”

Section: Uf Versus Diuretic Therapymentioning

confidence: 99%

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The Role of Peripheral Ultrafiltration in the Management of Acute Decompensated Heart Failure

Andrade

Stadnick²,

Virani³

2010

Blood Purif

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Heart failure is a common and highly morbid condition associated with recurrent hospitalizations for disease decompensation. As such, heart failure is a growing public health concern from both a utilization and cost perspective. The current standard of care for the management of volume overload symptoms is underpinned by a diuretic-based treatment regimen. There is now increasing data to suggest that this approach may be counterproductive and result in progression of cardiac and renal disease with resultant higher mortality rates. Peripheral ultrafiltration is emerging as a viable, and in some cases preferred, option for sodium and fluid removal. Initial research trials have shown that this treatment modality results in improved clinical, biochemical and quality of life parameters. Moreover, these benefits are durable over the long term with decreased recidivism and health care utilization at 1 year. It remains unclear whether these benefits will translate into hard cardiovascular endpoints; greater adoption of this technology coupled with newer clinical trials will help researchers and clinicians identify the optimal strategy for treating symptoms of volume overload among heart failure patients.

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Section: Uf Versus Diuretic Therapymentioning

confidence: 99%

Section: Uf Versus Diuretic Therapymentioning

confidence: 99%

The Role of Peripheral Ultrafiltration in the Management of Acute Decompensated Heart Failure

Andrade

Stadnick²,

Virani³

2010

Blood Purif

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“…UF, however, is the gold standard for sodium removal since the fluid removed is isotonic. 4,25,26,39,59 Therefore, even if patients experience similar degrees of fluid removal, total body sodium extraction is greater following UF compared to loop diuretics. Recent experience treating HF patients with vasopressin antagonists provides an opportunity to evaluate the effect of hypotonic volume removal since vasopressin antagonists result in the elimination of free water with very little sodium.…”

Section: -53mentioning

confidence: 99%

Ultrafiltration for Congestive Heart Failure

Thorsgard¹,

Bart²

2009

Congestive Heart Failure

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Relief of congestive symptoms is a primary goal in treating heart failure. Ultrafiltration is a tool that can be used to safely remove sodium and water from whole blood at a controlled rate. Ultrafiltration decreases symptoms, relieves congestion, and improves hemodynamics, neurohormonal balance, and exercise capacity. This article describes the importance of congestion as a therapeutic target in heart failure and outlines the development of ultrafiltration as a treatment to address this important physiologic state.

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“…16 Our group recently demonstrated that diuretics cannot accomplish the same task as ultrafiltration because the sodium concentration in urine is invariably lower than that in serum and in the ultrafiltrate. 17 Given the more effective volume extraction achieved with ultrafiltration compared with diuretic therapy, the differential sodium extraction with ultrafiltration vs diuretics greatly enhances the total quantity of excessive sodium extracted. 12,14 Thereby, the dual objective of adequate decongestion and adequate sodium extraction is realized.…”

Section: Efficacy and Safetymentioning

confidence: 99%

A Practical Guide for Ultrafiltration in Acute Decompensated Heart Failure

Dahle

Sobotka

Boyle

2008

Congestive Heart Failure

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Acute decompensated heart failure is the most common reason for inpatient hospital admission. Most patients admitted for decompensated heart failure are by definition diuretic‐resistant. The therapeutic objective for these patients is volume and sodium removal and restoration of diuretic sensitivity. In a significant proportion of patients, this objective is not met, subjecting patients to readmission for recurrent heart failure decompensation. Ultrafiltration therapy offers the potential of greater volume and sodium removal as compared with conventional therapies in a more expeditious manner. Ultrafiltration can be safely and effectively accomplished in a non‐intensive care setting but relies on earlier discharge with reduced readmission rates to be economically feasible. This paper reviews the current data regarding ultrafiltration therapy and provides a practical guide to patient selection, implementation and management of this therapy.

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Enhanced Sodium Extraction with Ultrafiltration Compared to Intravenous Diuretics

Cited by 15 publications

References 0 publications

The Role of Peripheral Ultrafiltration in the Management of Acute Decompensated Heart Failure

The Role of Peripheral Ultrafiltration in the Management of Acute Decompensated Heart Failure

Ultrafiltration for Congestive Heart Failure

A Practical Guide for Ultrafiltration in Acute Decompensated Heart Failure

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