Factors Determining the Need for Ultrafiltration in Cardiorenal Syndrome

This study investigates the factors determining the need for ultrafiltration (UF) in patients with cardiorenal syndrome presenting with hypervolemia-related symptoms and signs. A total of 88 patients hospitalized for hypervolemia were treated according to current guidelines, with UF employed as a rescue therapy when diuretic treatment failed to achieve adequate decongestion. Data collected included medical history, laboratory findings, blood pressures, diuretic doses, spot urine sodium (measured 6 hours after diuretic therapy), response to diuretics, postdischarge creatinine levels, rehospitalization rates, and mortality rates. UF was required in 23.90% of patients due to insufficient response to diuretics, with a higher rate observed in men (34.10%) compared with women (13.64%). Patients needing UF had lower systolic blood pressure, higher initial serum creatinine levels, and elevated pro-B-type natriuretic peptide levels. Statistical analysis showed that an increase in initial creatinine levels raised the risk of requiring UF by 6.443 times, while a one-unit decrease in urine sodium increased the risk by 1.037 times. These findings suggest that male gender, high pro-B-type natriuretic peptide levels, low spot urine sodium, low systolic blood pressure, and high initial creatinine levels may predict the need for UF. Further research involving larger patient cohorts is necessary to refine these criteria and develop a risk score.