Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis
Existing systematic reviews have insufficiently delineated the differing cardiac and renal profile of ultrafiltration compared to diuretics as a method of decongestion in acute decompensated heart failure. This meta-analysis will investigate the impact of ultrafiltration compared to diuretics on pro...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/2793 |
| _version_ | 1797604922707935232 |
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| author | Kirsty Luo-Yng Tay Abdel Rahman Osman Esyn Ee Xin Yeoh Jasmine Luangboriboon Jie Fei Lau Joanne Jia An Chan Majed Yousif Benjamin Yi Hong Tse Graham Horgan David T. Gamble Phyo Kyaw Myint |
| author_facet | Kirsty Luo-Yng Tay Abdel Rahman Osman Esyn Ee Xin Yeoh Jasmine Luangboriboon Jie Fei Lau Joanne Jia An Chan Majed Yousif Benjamin Yi Hong Tse Graham Horgan David T. Gamble Phyo Kyaw Myint |
| author_sort | Kirsty Luo-Yng Tay |
| collection | DOAJ |
| description | Existing systematic reviews have insufficiently delineated the differing cardiac and renal profile of ultrafiltration compared to diuretics as a method of decongestion in acute decompensated heart failure. This meta-analysis will investigate the impact of ultrafiltration compared to diuretics on prognostic cardiac and renal biomarkers. We searched PubMed Central, Ovid MEDLINE<sup>®</sup>, Ovid Embase, all EBM reviews, and Web of Science Core Collection for randomised controlled trials published before 21 July 2022. Our main outcome measures were cardiac (brain natriuretic peptide and N-terminal pro-brain natriuretic peptide) and renal biomarkers (serum creatinine, serum sodium, and blood urea nitrogen). A total of 10 randomised trials were included in our analysis after screening. An inverse-variance random effects meta-analysis of the pooled results demonstrated no significant difference between ultrafiltration and diuretics for brain natriuretic peptide, N-terminal pro-brain natriuretic peptide, creatinine, sodium and long-term blood urea nitrogen. However, ultrafiltration produced statistically greater increases in blood urea nitrogen in the short-term (mean difference, 3.88; 95% confidence interval 0.59–7.17 mg/dL). Overall, ultrafiltration produces a similar impact on prognostic cardiac and renal biomarkers when compared to diuretic therapy. We highlight ultrafiltration’s significant impact on short-term BUN and recommend further research to investigate more optimal protocols of ultrafiltration administration. |
| first_indexed | 2024-03-11T04:53:43Z |
| format | Article |
| id | doaj.art-14c1b64dd95448689e4a984feb0ae860 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:53:43Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-14c1b64dd95448689e4a984feb0ae8602023-11-17T19:48:34ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128279310.3390/jcm12082793Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-AnalysisKirsty Luo-Yng Tay0Abdel Rahman Osman1Esyn Ee Xin Yeoh2Jasmine Luangboriboon3Jie Fei Lau4Joanne Jia An Chan5Majed Yousif6Benjamin Yi Hong Tse7Graham Horgan8David T. Gamble9Phyo Kyaw Myint10School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKBiomathematics & Statistics Scotland, Aberdeen AB25 2ZD, UKAgeing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UKAgeing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UKExisting systematic reviews have insufficiently delineated the differing cardiac and renal profile of ultrafiltration compared to diuretics as a method of decongestion in acute decompensated heart failure. This meta-analysis will investigate the impact of ultrafiltration compared to diuretics on prognostic cardiac and renal biomarkers. We searched PubMed Central, Ovid MEDLINE<sup>®</sup>, Ovid Embase, all EBM reviews, and Web of Science Core Collection for randomised controlled trials published before 21 July 2022. Our main outcome measures were cardiac (brain natriuretic peptide and N-terminal pro-brain natriuretic peptide) and renal biomarkers (serum creatinine, serum sodium, and blood urea nitrogen). A total of 10 randomised trials were included in our analysis after screening. An inverse-variance random effects meta-analysis of the pooled results demonstrated no significant difference between ultrafiltration and diuretics for brain natriuretic peptide, N-terminal pro-brain natriuretic peptide, creatinine, sodium and long-term blood urea nitrogen. However, ultrafiltration produced statistically greater increases in blood urea nitrogen in the short-term (mean difference, 3.88; 95% confidence interval 0.59–7.17 mg/dL). Overall, ultrafiltration produces a similar impact on prognostic cardiac and renal biomarkers when compared to diuretic therapy. We highlight ultrafiltration’s significant impact on short-term BUN and recommend further research to investigate more optimal protocols of ultrafiltration administration.https://www.mdpi.com/2077-0383/12/8/2793ultrafiltrationdiureticsheart failurecreatininebrain natriuretic peptidesodium |
| spellingShingle | Kirsty Luo-Yng Tay Abdel Rahman Osman Esyn Ee Xin Yeoh Jasmine Luangboriboon Jie Fei Lau Joanne Jia An Chan Majed Yousif Benjamin Yi Hong Tse Graham Horgan David T. Gamble Phyo Kyaw Myint Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis Journal of Clinical Medicine ultrafiltration diuretics heart failure creatinine brain natriuretic peptide sodium |
| title | Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis |
| title_full | Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis |
| title_fullStr | Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis |
| title_short | Ultrafiltration versus Diuretics on Prognostic Cardiac and Renal Biomarkers in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis |
| title_sort | ultrafiltration versus diuretics on prognostic cardiac and renal biomarkers in acute decompensated heart failure a systematic review and meta analysis |
| topic | ultrafiltration diuretics heart failure creatinine brain natriuretic peptide sodium |
| url | https://www.mdpi.com/2077-0383/12/8/2793 |
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