• Hsin-Yu Chen, Kang-Ju Chou, Hua-Chang Fang, Chien-Liang Chen, Chih-Yang Hsu, Wei-Chieh Huang, Chien-Wei Huang, Chun Kai Huang, and Po-Tsang Lee.
• Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
• Nephron. 2015 Jan 1;129(3):189-96.

BackgroundUltrafiltration is an adjunctive treatment for decompensated heart failure patients with cardiorenal syndrome. The efficacy and safety of ultrafiltration in the patient cohort are still unknown.MethodsWe systematically reviewed and evaluated randomized controlled trials, comparing diuretics with ultrafiltration in adult patients with decompensated heart failure and cardiorenal syndrome through January 2014. The primary outcomes were body weight loss and total fluid removal.ResultsWe identified 8 trials including 608 patients. In a random-effects model, the pooled difference of body weight loss was 1.44 kg between patients receiving ultrafiltration and diuretics (95% CI, 0.29-2.59; p = 0.01). The difference of fluid removal was 1.28 l between groups (95% CI, 0.43-2.12; p = 0.003). The RR for mortality was 0.90 for ultrafiltration compared with diuretics (95% CI, 0.61-1.33; p = 0.60) and the RR for renal function deterioration was 1.29 (95% CI, 0.90-1.85; p = 0.17). There is a trend toward reducing readmission rate in ultrafiltration group.ConclusionsUltrafiltration is a safe and effective strategy in the treatment of cardiorenal syndrome without increasing the risk of renal deterioration.

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