Results of the UNLOAD Study
The official name of the UNLOAD study is "Ultrafiltration versus IV Diuretics for Patients Hospitalized for Acute Decompensated Congestive Heart Failure." Two hundred patients were enrolled in the trial, and they were divided into two groups -- one received diuretic treatment and the other received ultrafiltration treatment.
The study showed that hospitalized heart failure patients receiving ultrafiltration therapy lost more weight (from fluid loss) and experienced greater net fluid loss than patients treated primarily with diuretics. By 90 days after treatment, the ultrafiltration group had spent significantly fewer days in the hospital and had fewer repeat hospitalizations for heart failure. The group that received ultrafiltration also had fewer trips to the emergency room for heart failure and fewer unscheduled visits to the doctor for heart failure.
Ultrafiltration can remove as much as a pound of excess salt and water from the bloodstream each hour. Most patients undergoing this procedure stay in the hospital for an average of about three to four days.
For more information about heart failure, please take a look at the links below.
- How Your Heart Works
- How Your Lungs Work
- How Your Kidneys Work
- How Blood Works
- How Ultrafiltration Works
- How Vasodilator Drugs Work
- How Fluid Overload and Edema Work
- How Orthopnea Works
- How Jugular Venous Distension Works
- How Heart Failure Affects Quality of Life
- How Inotropic Drugs Work
- How Diuretics Work
- How Low-Sodium Diets Work
More Great Links
- Adams KF, Lindenfeld J, Arnold JMO, et al. Heart Failure Society of America (HFSA) 2006 Comprehensive Heart Failure Practice Guideline. J Cardiac Failure 2006;12:e1-e122.
- Agostoni P, Marenzi G, Lauri G, et al. Sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency: failure of furosemide to provide the same result. Am J Med. 1994;96:191-199.
- Agostoni P, Marenzi GC, Pepi M, et al. Isolated ultrafiltration in moderate congestive heart failure. J Am Coll Cardiol. 1993;21:424-431.
- Ahmed A, Young JB, Love TE, et al. A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure. Int J Cardiol. 2007. [Epub ahead of print].
- Bart B, Boyle A, Bank AJ, et al. The RAPID Study: Ultrafiltration versus usual care for hospitalized patients with heart failure: the Relief for Acutely Fluid-Overloaded Patients With Decompensated Congestive Heart Failure. J Am Coll Cardiol. 2005;46:2043-2046.
- Costanzo MR, Guglin ME, Saltzberg MT, et al. The UNLOAD Study: Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007; 49:675-683. www.unloadstudy.com
- Costanzo MR, Saltzberg M, O'Sullivan J, et al. The EUPHORIA Study: Early ultrafiltration in patients with decompensated heart failure and diuretic resistance. J Am Coll Cardiol. 2005;46:2047-2051.
- Elkayam U, Hatamizadeh P, Janmohamed M. The challenge of correcting volume overload in hospitalized patients with decompensated heart failure. J Am Coll Cardiol. 2007;49:684-686.
- Eshaghian S, Horwich TB, Fonarow GC. Relation of loop diuretic dose to mortality in advanced heart failure. Am J Cardiol. 2006;97:1759-1764.
- Jaski B, Ha J, Denys BG, et al. The SAFE Study: Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients. J Card Fail. 2003;9:227-231.
- Marenzi G, Lauri G, Grazi M, et al. Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure. J Am Coll Cardiol. 2001;38:963-968.
- Mehta RL, Pascual MT, Soroko S, et al. Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA. 2002;288:2547-2553.
- Pepi M, et al. Sustained cardiac diastolic changes elicited by ultrafiltration in patients with moderate congestive heart failure: pathophysiological correlates. Br Heart J. 1993;70:135-140.