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Updated: May 19, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
Supplementary ultrafiltration may improve inflammation and cardiac dysfunction in patients with high interdialytic
Rahmi Yilmaz1, Mustafa Arici, Tolga Yildirim
1Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey. ryilmaz @ hacettepe.edu.tr
Background/Aims:
We tested the hypothesis that adding an ultrafiltration session per week may improve brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels and left ventricular function in hypervolemic hemodialysis patients.
Methods:
Twenty-six patients (18 male, 8 female; mean age 57.2 ± 12.7 years) who had high BNP and CRP levels and interdialytic weight gain (IDWG) were recruited for the study. Patients were randomly allocated to one of two groups, namely the supplementary ultrafiltration (sUF) group (n = 13), who had additional ultrafiltrations for 8 weeks, and the regular hemodialysis (rHD) group (n = 13), who continued regular dialysis treatments.
Results:
There were significant decreases in mean CRP and BNP levels and mean arterial blood pressure and significant improvements in left ventricular function in the sUF group, with no changes in the rHD group. Higher IDWG was observed in the rHD group compared to the sUF group after 8 weeks.
Conclusion:
sUF may be effective in reducing inflammatory burden and improving cardiac function.
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