The Influence Of Ultrafiltration On Heart And Kidney Function Of ACHF Patients

Objective This study was designed to explore the Influence of ultrafiltration on heart and kidney function of ACHF patients,and to evaluate the security of ultrafiltration treatment, it aimed to offer more evidence for ultrafiltration treatment of ACHF.Methods Part 1. Selecting objects60 hospitalized patients at hunan provincial people’s hospital from April 2014 to April 2016 were selected into our study, who were diagnosed as ACHF and conformed with inclusion and exclusion criteria of this study.Part 2. ultrafiltration treatment program ACHF patients were treated with FQ-16 ultrafiltration device until overload liquid symptoms were improved. Ultrafiltration rate, total ultrafiltration volume and ultrafiltration time were based on heart rate,blood pressure and the degree of hypervolemia. Meanwhile, the vital signs, blood pump rate, arterial pressure, ultrafiltration pressure,transmembrane pressure, ultrafiltration volume, ultrafiltration time and ultrafiltration rate were recorded. Anticoagulation plan was given during ultrafiltration treatment. Diuretics weren’t used during ultrafiltration treatment.Part 3. Acquiring evaluation indicators data Evaluation indicators were collected at the begin of ultrafiltration and at 48 h after treatment. Dyspnea assessment, weight and hypervolemia signs were set as the water sodium retention indicators. ST2, CA125,NT-pro BNP, LVEF were set as the cardiac function evaluation indicators.NGAL, e GFR, Cys C, creatinine, urea nitrogen were set as renal function related evaluation indicators. This study set continuous detection of vital signs and ECG, oxygen saturation monitoring, blood routine, electrolytes,hypotension and other adverse events(including renal failure, other cardiovascular diseases, etc.), catheter-related complications(bleeding,infection, blood clots, etc.) as safety evaluation indicators.Results:1. After ultrafiltration treatment, dyspnea assessment and hypervolemia signs were significantly improved, body weight was significantly reduced of patients with ACHF compared with pre-treatment,it has significantly statistical difference(P<0.05).2. After ultrafiltration treatment, ST2, CA125, NT-Pro BNP were decreased, and LVEF was increased, it has significantly statistical difference(P <0.05).3. After ultrafiltration treatment, renal functon indicators of ACHF patients such as NGAL, e GFR, Cys C, Cr, BUN had no significant statistic changes(P >0.05).4. During ultrafiltration treatment, electrolyte(Na+, K+), blood(WBC, PT, Hb, HCT), blood pressure, oxygen saturation and heart rate had no significant statistic changes(P> 0.05). No cardiac electrical activity disorders, hemodynamic instability, cardiovascular events(myocardial infarction, sudden death), and catheter-related complications(bleeding, infection, thrombosis) and other adverse events occured during the ultrafiltration.Conclusion:1. Ultrafiltration treatment can effectively alleviate body weight and improve dyspnea assessment and hypervolemia signs of ACHF patients.2. Ultrafiltration treatment can improve LVEF and decrease the expression of ST2, CA125, NT-Pro BNP of ACHF patients.3. Ultrafiltration had no influence on renal function, electrolyte,blood routine, blood pressure, heart rate, oxygen saturation. No adverse events happened during ultrafiltration treatment.