title: Continuous renal replacement therapy versus furosemide for management of kidney impairment in heart transplant recipients with volume overload.
abstract: OBJECTIVE
  It is unknown whether continuous renal replacement therapy or furosemide therapy is superior in heart transplant recipients who are in postoperative kidney insufficiency and volume overload. This prospective non-randomized, controlled trial investigated the efficacy of the two methods after transplantation.
  
  
  METHODS
  We assigned heart transplant recipients 18 years of age or older who were oliguric (urine output < 400 ml/day); had volume overload and estimated glomerular filtration rate <60 ml/min/1.73 m(2) of body surface area calculated with the use of the Modification of Diet in Renal Disease equation, to designed initiation of intervention. We followed 30 patients for up to 30 days. The primary outcome was estimated glomerular filtration rate status after intervention.
  
  
  RESULTS
  Between January 2010 and April 2012, a total of 30 adults (mean age: 37 years; 18 men and 12 women) were assessed for entry in this trial. Continuous renal replacement therapy, when compared with furosemide, was associated with a significant increase in estimated glomerular filtration rate of patients after intervention 61 ± 4.5 vs 55 ± 8.5l ml/min/1.73 m(2) (P = 0.02). Moreover, the mean glomerular filtration rate at discharge time for the continuous renal replacement therapy group was 72 ± 7.3 and 58 ± 7.4 ml/min/1.73 m(2) for the furosemide group (P < 0.001). During the follow-up period, 6 of 15 patients in the continuous renal replacement therapy group (40%) and 4 of 15 in the furosemide group (26.6%) died (P = 0.43).
  
  
  CONCLUSIONS
  In this study, continuous renal replacement therapy in heart transplant recipients with reduced kidney function was associated with an improvement in estimated glomerular filtration rate status in comparison with furosemide.
authors.affiliation: Chronic Respiratory Disease Research Center,  National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran,  Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Mirhosseini
authors.forename: Mohammad
authors.initials: M
authors.lastname: Fakhri
authors.forename: Shadi
authors.initials: S
authors.lastname: Asadollahi
authors.forename: Zargham Hossein
authors.initials: ZH
authors.lastname: Ahmadi
authors.forename: Farin
authors.initials: F
authors.lastname: Rashid Farokhi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Boloursaz
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Masjedi
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D016009:Chi-Square Distribution; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007492:Iran; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D005665:Furosemide