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In studies of patients with chronic severe CHF refractory to medical therapy (including loop diuretics), isolated ultrafiltration was frequently able to relieve congestive symptoms by precise removal of extracellular water and sodium, and in some cases was able to restore responsiveness to loop diuretics. Randomized controlled trials comparing isolated ultrafiltration and medical therapy (mainly loop diuretics) in patients with ADHF failed to demonstrate the superiority of isolated ultrafiltration over diuretic therapy with respect to renal function and mortality. Isolated ultrafiltration reduced length of hospital stay in several studies. At this time, there is insufficient evidence to support the use of isolated ultrafiltration as initial therapy of ADHF.<\/jats:p>","DOI":"10.1111\/hdi.12464","type":"journal-article","created":{"date-parts":[[2016,9,26]],"date-time":"2016-09-26T19:00:30Z","timestamp":1474916430000},"source":"Crossref","is-referenced-by-count":2,"title":["Role of isolated ultrafiltration in the management of chronic refractory and acute decompensated heart failure"],"prefix":"10.1111","volume":"20","author":[{"given":"Mayank K.","family":"MITTAL","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine University of Missouri School of Medicine Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natraj","family":"KATTA","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Missouri School of Medicine Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"ALPERT","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Missouri School of Medicine Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2013.09.009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.191259"},{"key":"e_1_2_11_4_1","first-page":"e391","article-title":"2009 Focused update incorporated into the ACC\/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: A report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines: Developed in collaboration with the International Society for Heart and Lung Transplantation","volume":"119","author":"Hunt SA","year":"2009","journal-title":"Circulation."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.067"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph6070851"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.09.022"},{"key":"e_1_2_11_8_1","first-page":"53","article-title":"Who has higher readmission rates for heart failure, and why?: Implications for efforts to improve care using financial incentives","volume":"4","author":"Joynt KE","year":"2011","journal-title":"Circulation."},{"key":"e_1_2_11_9_1","first-page":"91","article-title":"Recent national trends in readmission rates after heart failure hospitalization","volume":"3","author":"Ross JS","year":"2010","journal-title":"Circulation."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.08.036"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.001088"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-008-0054-5"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq136"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp507"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2006.10.005"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.09.014"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02910313"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7133.2008.07649.x"},{"key":"e_1_2_11_19_1","first-page":"499","article-title":"Treatment of congestion in congestive heart failure. 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