Among all cardiac diseases, congestive heart failure (CHF) is the leading cause of patient rehospitalization. Fluid overload and lung congestion are the major reasons for these recurrent admissions. This disease can be associated with worsening renal function, a phenomenon called cardiorenal syndrome (CRS), which is challenging to manage. Conventional diuretic therapy of both CRS and diuretic resistance has offered limited efficacy. Compared with conventional therapy, hemodiafiltration (HDF) has shown promising results for fluid removal in some clinical trials, with inconclusive effects on all-cause mortality and rehospitalizations. Nonetheless, the results are inconsistent because of the high heterogeneity among these studies. In this chapter, we shed light on the role of different methods of ultrafiltration, including peritoneal ultrafiltration, sustained slow efficiency dialysis, and HDF, in the management of CHF, and review the current literature.
Part of the book: Advances in Hemodiafiltration