A growing number of people today suffer from heart failure -- people are living longer and the risk of developing this condition increases with age. According to the American Heart Association, more elderly people are hospitalized for heart failure than for any other condition. The National Institutes of Health estimates that one out of every 100 people over the age of 65 will be diagnosed with heart failure.
In the United States, more than a million heart failure patients are admitted to the hospital each year -- resulting in health care costs of nearly $29 billion.
In heart failure, the heart's muscular contractions become weaker and less effective over time. When this happens, there's a tendency for excess fluid to build up in the body. Doctors traditionally use diuretic drugs, which help flush fluids from the body, to treat heart failure patients who have symptoms of fluid overload.
There are several different types of diuretic drugs -- loop diuretics are the strongest. But unfortunately, diuretics are often not effective in relieving the symptoms of fluid overload in heart failure patients. In fact, data show that most hospitalizations for heart failure are fluid-overloaded patients for whom oral diuretic drugs are no longer working. Even though 90 percent of patients in these circumstances are treated with intravenous diuretic drugs, a significant percentage of them fail to achieve relief upon release from the hospital, and many of them are readmitted to the hospital later.
Diuretic resistance is a term for the condition from which some of these patients suffer. It happens when diuretics don't flush out enough excess fluid, and it's particularly likely to occur in patients with moderate or severe heart failure.
Ultrafiltration is an alternative to diuretics. Researchers designed a clinical study to compare the safety and efficacy of ultrafiltration with that of diuretic drugs. The official name of the study was the Relief for Acutely Fluid Overloaded Patients with Decompensated Congestive Heart Failure trial, which was nicknamed the RAPID-CHF study. We'll discuss the results of the study on the next page.