Ultrafiltration for congestive heart failure: the past and the present

Purpose of review To provide an overview on the most recent evidence for the use of extracorporeal and peritoneal ultrafiltration in heart failure, focusing on the major publications from the last few years. Recent findings There have been several studies investigating the possible use of extracorporeal and peritoneal ultrafiltration in the management of acute and chronic heart failure. These trials have investigated the potential benefits and advantages of ultrafiltration over conventional medical therapy, in terms of clinical outcomes. Summary Although ultrafiltration remains an extremely appealing therapeutic option for patients with heart failure and congestion, with several theoretical beneficial effects, some of the most recent studies have reported inconsistent findings. Differences in the selection of the study population, heterogeneity of the indications for use of ultrafiltration, variation in the ultrafiltration protocols, and high variability in the pharmacologic therapy used for the control group could explain some of these conflicting findings.