Effect of ultrafiltration on the renal function in the treatment of patients with acute heart failure: A meta-analysis / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effect of uhrafiltration on the renal function in the treatment of patients with acute heart failure.Methods We retrieved as high a proportion as possible of relevant randomized controlled trials (RCT) from PubMed,EMBASE,Cochrane Library,Cochrane clinic test center registration bank and Wanfang database.This meta-analysis was performed by searching RCT study literatures on the prognosis of patients with acute heart failure treated with uhrafiltration and by screening the search results according to the PRISMA declaration.Results We identified 12 RCTs with a total of 1,070 participants involved.Overall,as compared with routine diuretics treatment,ultrafiltration treatment did not significantly affect the serum creatinine levels [standard mean difference (SMD =-0.18,95％ CI-0.47 to 0.10,P =0.21)],the estimated glomerular filtration rate (SMD=-0.38,95％ CI-1.03 to 0.27,P=0.25),and the incidence rate of renal failure (RR =1.25,95％ CI0.88 to 1.77,P =0.21).But,ultrafiltration treatment was associated with decreased serum sodium level (SMD =-0.38,95 ％ CI-0.67 to-0.08,P =0.01),increased net fluid extraction volume (SMD =1.06,95 ％ CI0.29 to 1.83,P =0.007),and decreased body weight (SMD =-1.34,95％ CI-1.98 to-0.71,P ＜ 0.001) Conclusions Although ultrafiltration increases the fluid extraction and decreases the fluid retention,the renal function and risk of renal failure in patients with acute heart failure are not significantly changed.