Evaluation of ultrafiltrated fluid overloaded patients: a single center study

Abstract

Aims: Fluid overloaded patients with heart or renal insufficiency have poor quality of life and increased morbidity and mortality. In this study, we aimed to investigate the factors affecting the prognosis in patients who presented with fluid overload and were ultrafiltered. Methods: Three groups of patients were compared: Group 1: Patients with chronic kidney disease and ejection fraction ≤ 40%; Group 2: Patients with chronic kidney disease and ejection fraction > 40%; Group 3: Patients with ejection fraction ≤ 40% but without chronic kidney disease. Patients were also evaluated regarding mortality. Results: Group 1, 2 and 3 consisted of 14, 62 and 16 patients: respectively. There were statistically significant results for 24-hour urine volume (p=0.040), proteinuria (p=0.010), ultrafiltration volume/weight at hospitalization (p<0.001), ejection fraction (p<0.001), left ventricular hypertrophy (p=0.040), uric acid (p<0.001), hemoglobin (p<0.001), dialysis dependency after hospital discharge (p<0.001) and mortality (p<0.001) when three groups were compared. However, there was no statistically significant result for ultrafiltration volume (p=0.100). Compared to survived patients those who did not survived were significantly older (p<0.001), had lower ejection fraction (p=0.010), creatinine (p<0.001), sodium (p=0.020), ferritin (p=0.040), proteinuria (p=0.010). They also had statistically significantly higher hemoglobin (p<0.001), creatinine clearance (p<0.001), uric acid (p<0.001) levels. However, the percentage of patients using loop diuretics at hospitalization (p=0.040) was higher in the group who survived. Conclusion: Patients with HF were more prone to hypervolemia and mortality. The ultrafiltration volume/weight at hospitalization and serum uric acid levels were also significantly higher in these patients. Patients with chronic kidney disease had significantly higher proteinuria, creatinine and lower hemoglobin levels. The rate of loop diuretic usage at hospitalization was significantly higher in the survived group.

Keywords

• Dialysis
• ejection fraction
• heart failure
• loop diuretics
• left ventricular hypertrophy
• mortality
• ultrafiltration

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