Is Aquapheresis ready for prime time yet for congestive heart failure? A systemic review of the literature

Renal Replacement Therapy

Review

John Afif¹  Muhammad Junaid Alvi²  Syeda Sahra³  Suzanne Elsayegh⁴  Elie El-Charabaty⁴  Aneeqa Javed⁴ 

[1] City University of New York, 02691, New York, NY, USA;Mount Sinai Hospital, 10305, Manhattan, NY, USA;Oklahoma University of Health Sciences Center, 73117, Oklahoma City, OK, USA;Staten Island University Hospital, 10305, New York, NY, USA;

关键词: Heart failure;    Aquapheresis;    Ultrafiltration;    Volume overload;   

DOI  :  10.1186/s41100-023-00477-0

 received in 2023-01-27, accepted in 2023-05-02,  发布年份 2023

来源: Springer

【 摘 要 】

Heart failure is a clinical syndrome with considerable morbidity and mortality rates. Recent data published by National Health and Nutrition Examination Survey (NHANES) showed that 6 million Americans are diagnosed with CHF. The prevalence of CHF is expected to increase by 46% from 2012 to 2030. The current therapy for acute CHF exacerbation involves the use of oral or intravenous diuretics. Aquapheresis is a form of slow continuous ultrafiltration where blood is removed by applying negative pressure by the machine, which is then passed through the unique filter across which a set fraction of plasma water is filtered each minute before it is pumped back into the patient. It is almost exclusively used in congestive heart failure patients who are found to be resistant to incremental doses of intravenous diuretics. Several trials have shown that aquapheresis or ultrafiltration (UF) produces more significant reductions in weight and may even decrease the rehospitalization rate within 90 days; however, a greater sample size is needed to obtain results of better statistical significance. Since UF does not improve survival in patients with heart failure, limiting factors to its use include cost, the need for a multidisciplinary team, catheter-related adverse events, and renal side effects. Guidelines need to be established for its use in heart failure.

【 授权许可】

CC BY   
© The Author(s) 2023