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Effi cacy and Renal Tolerability of ultrafi ltration in Acute Decompensated Heart Failure: A Meta-analysis and Systematic Review of 19 Randomized Controlled Trials

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Cardiovascular Innovations and Applications 2021年第3期6卷 1-16页

作者： Yajie Liu Xin Yuan Department of Cardiology the Second Affi liated Hospital of Chongqing Medical UniversityChongqingChina Department of Nephrology the Second Affi liated Hospital of Chongqing Medical UniversityChongqingChina

Background:Acute decompensated heart failure(ADHF)is a life-threatening and costly *** re-mains regarding the effi cacy and renal tolerability of ultrafi ltration for treating *** therefore performed this meta-analysis to evaluate this clinical ***:A search of PubMed,EMBASE,and the Cochrane database of controlled trials was performed from in-ception to March 2021 for relevant randomized controlled *** quality of the included trials and outcomes was evaluated with the use of the risk of bias assessment tool and the Grading of Recommendations,Assessment,Develop-ment and Evaluation(GRADE)approach,*** risk ratio and the standardized mean difference(SMD)or weighted mean difference(WMD)were computed and pooled with fi xed-effects or random-effects ***:This meta-analysis included 19 studies involving 1281 *** ltration was superior to the control treatments for weight loss(WMD 1.24 kg,95%confi dence interval[CI]0.38-2.09 kg,P=0.004)and fl uid removal(WMD 1.55 L,95%CI 0.51-2.59 l,P=0.003)and was associated with a signifi cant increase in serum creatinine level compared with the control treatments(SMD 0.15 mg/dL,95%CI 0.00-0.30 mg/dL,P=0.04).However,no signifi cant effects were found for serum N-terminal prohormone of brain natriuretic peptide level,length of hospital stay,all-cause mortality,or all-cause rehospitalization in the ultrafi ltration ***:The use of ultrafi ltration in patients with ADHF is superior to the use of the control treatments for weight loss and fl uid removal,but has adverse renal effects and lacks signifi cant effects on long-term prognosis,in-dicating that this approach to decongestion in ADHF patients is effi cient for fl uid management but less safe renally.

关键词： ultrafi ltration diuretic acute decompensated heart failure meta-analysis

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