Development of a new miniaturized system for ultrafiltration.

Luca Sgarabotto, Alessandra Brendolan, Anna Lorenzin, Thiago Reis, Monica Zanella, Claudio Ronco, Gonzalo Ramírez-Guerrero

Journal: Heart failure reviews 2024;29(3):615-630

PMID: 38289525

Abstract

Acute decompensated heart failure and fluid overload are the most common causes of hospitalization in heart failure patients, and often, they contribute to disease progression. Initial treatment encompasses intravenous diuretics although there might be a percentual of patients refractory to this pharmacological approach. New technologies have been developed to perform extracorporeal ultrafiltration in fluid overloaded patients. Current equipment allows to perform ultrafiltration in most hospital and acute care settings. Extracorporeal ultrafiltration is then prescribed and conducted by specialized teams, and fluid removal is planned to restore a status of hydration close to normal. Recent clinical trials and European and North American practice guidelines suggest that ultrafiltration is indicated for patients with refractory congestion not responding to medical therapy. Close interaction between nephrologists and cardiologists may be the key to a collaborative therapeutic effort in heart failure patients. Further studies are today suggesting that wearable technologies might become available soon to treat patients in ambulatory and de-hospitalized settings. These new technologies may help to cope with the increasing demand for the care of chronic heart failure patients. Herein, we provide a state-of-the-art review on extracorporeal ultrafiltration and describe the steps in the development of a new miniaturized system for ultrafiltration, called AD1 (Artificial Diuresis).

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Address: International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy.; Nephrology and Dialysis Unit, Carlos Van Buren Hospital, Valparaíso, Chile.; Departamento de Medicina Interna, Universidad de Valparaíso, Valparaíso, Chile.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy. [email protected].; Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy. [email protected].; Department of Medicine (DIMED), Università degli Studi di Padova, Padua, Italy. [email protected].; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy.; Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy.; Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy.; Department of Medicine (DIMED), Università degli Studi di Padova, Padua, Italy.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy.; Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Brasília, Brazil.; Department of Nephrology and Kidney Transplantation, Fenix Group, Sao Paulo, Brazil.

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