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Copyright ©The Author(s) 2023.
World J Cardiol. May 26, 2023; 15(5): 205-216
Published online May 26, 2023. doi: 10.4330/wjc.v15.i5.205
Table 2 Overview of most relevant randomized controlled trials on ultrafiltration-based decongestive therapy
RCTs
Target population
UF device
Primary and secondary endpoint
Results
RAPID-CHF (2005)ADHF, n = 40Aquadex system, 8-h courseWeight loss at 24 h of treatment (Primary endpoint); Volume removal after 24 hWeight reduction resulted not statistically significant (P = 0.24); Volume removal was significantly more in UF arm (P < 0.001)
UNLOAD (2007)ADHF, n = 200Aquadex System, Mean fluid removal rate 241 mL/hWeight loss at 48 h; Dyspnea score at 48 hWeight loss resulted significantly increased in UF arm (P < 0.001), whereas there were no differences between groups in Dyspnea score (P = 0.588)
ULTRADISCO (2011)ADHF, n = 30PRISMA, treatment duration 46 hChanges in hemodynamics assessed using PRAM: SVi, CI, CPO, SVR were measured during hospitalization, at discharge, and at 1 and 3-mo follow-upUF arm as compare to standard care had a significant improvement of global hemodynamic status
CARRESS-HF (2012)ADHF, n = 188; Recent increase in serum creatinin >/= 0.3 mg/dLAquadex System at a fixed rate of 200 mL/hBivariate changes in sCr and change in weight 96 h after randomization

CUORE (2014)ADHF, LVEF </=40%, n = 56Dedyca systemHF rehospitalization at 1 yrUF arm has a significant lower endpoint incidence (P = 0.002)
AVOID-HF (2016)ADHF, n = 224Aquadex system at an ajdusted rate on a per protocol established basisTime to first HF event (HF rehospitalization or unscheduled outpatient or emergency treatment with intravenous loop diuretic agents or UF) within 90 days of hospital discharge30-d HF rehospitalizations: 11 of 2876 (UF arm) vs 24 of 2882 (diuretics arm), P = 0.06
Hu et al[49], 2021ADHF, n = 100FQ-16 type HF ultrafiltration dehydration device (Beijing Hartcare Medical Technology Co., Ltd)Weight loss and an increase in urine output on days 4 and 8 of treatment; Secondary outcome evaluated: BNP, NYHA class, IVC collapse index, JVPEarly ultrafiltration group had a significantly greater weight loss (P < 0.001) than the torasemide + tolvaptan group and urine increase (P < 0.001); Secondary outcomes that were followed up demonstated a clear trend towards benefits of UF as compared to diuretics arm