title: Continuous ultrafiltration for congestive heart failure: the CUORE trial.
abstract: BACKGROUND
  There are limited data comparing ultrafiltration with standard medical therapy as first-line treatment in patients with severe congestive heart failure (HF). We compared ultrafiltration and conventional therapy in patients hospitalized for HF and overt fluid overload.
  
  
  RESULTS
  Fifty-six patients with congestive HF were randomized to receive standard medical therapy (control group; n = 29) or ultrafiltration (ultrafiltration group; n = 27). The primary end point of the study was rehospitalizations for congestive HF during a 1-year follow-up. Despite similar body weight reduction at hospital discharge in the 2 groups (7.5 ± 5.5 and 7.9 ± 9.0 kg, respectively; P = .75), a lower incidence of rehospitalizations for HF was observed in the ultrafiltration-treated patients during the following year (hazard ratio 0.14, 95% confidence interval 0.04-0.48; P = .002). Ultrafiltration-induced benefit was associated with a more stable renal function, unchanged furosemide dose, and lower B-type natriuretic peptide levels. At 1 year, 7 deaths (30%) occurred in the ultrafiltration group and 11 (44%) in the control group (P = .33).
  
  
  CONCLUSIONS
  In HF patients with severe fluid overload, first-line treatment with ultrafiltration is associated with a prolonged clinical stabilization and a greater freedom from rehospitalization for congestive HF.
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy. Electronic address: giancarlo.marenzi@ccfm.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Marenzi
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.affiliation: Department of Internal Medicine Hypertension Centre-Heart Failure Centre, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Eugenio R
authors.initials: ER
authors.lastname: Cosentino
authors.affiliation: Division of Nephrology, Dialysis and Hypertension, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Rinaldi
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Donghi
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Milazzo
authors.affiliation: Division of Nephrology, Dialysis and Hypertension, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Emiliana
authors.initials: E
authors.lastname: Ferramosca
authors.affiliation: Department of Internal Medicine Hypertension Centre-Heart Failure Centre, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Division of Nephrology, Dialysis and Hypertension, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000187:drug effects; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016001:Confidence Intervals; D004232:Diuretics / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010359:Patient Readmission / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014462:Ultrafiltration / Q000379:methods*
chemical_list: D002317:Cardiovascular Agents; D004232:Diuretics; D020097:Natriuretic Peptide, Brain; D005665:Furosemide
keywords: Congestion; diuretics; heart failure; ultrafiltration