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

IF 1.5 4区医学 Q3 HEMATOLOGY Therapeutic Apheresis and Dialysis Pub Date : 2024-02-01 Epub Date: 2023-07-19 DOI:10.1111/1744-9987.14037

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

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Abstract

Introduction: Hospitalization for decompensated heart failure is a major public health issue.

Methods: We 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.

Results: Compared 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.

Conclusion: Among patients with decompensated heart failure, compared to diuretics, ultrafiltration is associated with reduced rehospitalizations and increased weight/net fluid loss.

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治疗急性失代偿性心力衰竭的利尿剂或超滤疗法：最新系统综述和荟萃分析。

导言失代偿性心力衰竭住院治疗是一个重大的公共卫生问题：我们进行了一项荟萃分析，总结并分析了在降低死亡率或再住院率方面，使用超滤治疗是否比使用利尿剂更有益处，主要确定了10项随机对照试验（RCT），包括941名患者：与利尿剂相比，超滤治疗可显著降低心衰住院率（风险比 [RR]：0.72；95% 置信区间 [CI]：0.55-0.96，P = 0.02），并可显著增加体重和净体液流失量（平均差 [MD]：-1.55，CI：-2.36 至 -0.74，P = 0.0002）和（MD：-2.10，CI：-3.32 至 -0.89，P = 0.0007）。不同治疗方法在住院时间、血清肌酐水平升高和死亡率方面没有明显差异：结论：在失代偿性心力衰竭患者中，与利尿剂相比，超滤与减少再住院和增加体重/净体液丢失有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Apheresis and Dialysis 医学-泌尿学与肾脏学

CiteScore

3.00

自引率

10.50%

发文量

166

审稿时长

6-12 weeks

期刊介绍： Therapeutic Apheresis and Dialysis is the official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis and the Japanese Society for Dialysis Therapy. The Journal publishes original articles, editorial comments, review articles, case reports, meeting abstracts and Communications information on apheresis and dialysis technologies and treatments.