title: Cardiorenal rescue study in acute decompensated heart failure: rationale and design of CARRESS-HF, for the Heart Failure Clinical Research Network.
abstract: BACKGROUND
  Worsening renal function is common among patients hospitalized for acute decompensated heart failure (ADHF). When this occurs, subsequent management decisions often pit the desire for effective decongestion against concerns about further worsening renal function. There are no evidence-based treatments or guidelines to assist in these difficult management decisions. Ultrafiltration is a potentially attractive alternative to loop diuretics for the management of fluid overload in patients with ADHF and worsening renal function.
  
  
  RESULTS
  The National Heart, Lung, and Blood Institute Heart Failure Clinical Research Network designed a clinical trial to determine if ultrafiltration results in improved renal function and relief of congestion compared with stepped pharmacologic care when assessed 96 hours after randomization in patients with ADHF and cardiorenal syndrome. Enrollment began in June 2008. This paper describes the rationale and design of the Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF).
  
  
  CONCLUSIONS
  Treating the signs and symptoms of congestion in ADHF is often complicated by worsening renal function. CARRESS-HF compares treatment strategies (ultrafiltration vs stepped pharmacologic care) for the management of worsening renal function in patients with ADHF. The results of the CARRESS-HF trial are expected to provide information and evidence as to the most appropriate approaches for treating this challenging patient population.
authors.affiliation: University of Minnesota, Minneapolis, Minnesota, USA. bartx006@umn.edu
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Bart
authors.forename: Steven R
authors.initials: SR
authors.lastname: Goldsmith
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Lee
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Redfield
authors.forename: G Michael
authors.initials: GM
authors.lastname: Felker
authors.forename: Christopher M
authors.initials: CM
authors.lastname: O'Connor
authors.forename: Horng H
authors.initials: HH
authors.lastname: Chen
authors.forename: Jean L
authors.initials: JL
authors.lastname: Rouleau
authors.forename: Michael M
authors.initials: MM
authors.lastname: Givertz
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Semigran
authors.forename: Douglas
authors.initials: D
authors.lastname: Mann
authors.forename: Anita
authors.initials: A
authors.lastname: Deswal
authors.forename: David A
authors.initials: DA
authors.lastname: Bull
authors.forename: Martin M
authors.initials: MM
authors.lastname: Lewinter
authors.forename: Eugene
authors.initials: E
authors.lastname: Braunwald
mesh_terms: D000208:Acute Disease; D035843:Biomedical Research / Q000379:methods* / Q000639:trends; D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D011446:Prospective Studies