Daily hemofiltration in severe heart failure

We treated nine patients having severe heart failure (IV NYHA classification) with anuria resistant to diuretics who were on daily hemofiltration, and estimated their survival for a year. The total volume of liquids removed was estimated by means of an echographic determination of the caval collapsability index. Dry weight was obtained from 6 to 22 days. The fluid removed varied from 10 to 35 liters. Five patients at the end of the therapy took up diuresis again and recovered their sensitivity to diuretics. Three of these patients went beyond the 12 months of survival, and two patients died earlier. Four patients did not show the resumption of diuresis and they continued with daily hemofiltration. Three survived over 20 weeks; one died after 15 weeks. We conclude that daily hemofiltration is useful in patients with severe heart decompensation in that it increases their survival rate.