Extracorporeal Ultrafiltration in Heart Failure and Cardio-Renal Syndromes

Seminars in Nephrology

Volumn 32, Issue 1, 2012, Pages 100-111

  Costanzo, Maria Rosa ^a   Cozzolino, Mario ^b   Aspromonte, Nadia ^c   Mistrorigo, Flavio ^d   Valle, Roberto ^e   Ronco, Claudio ^d,f  

^a Midwest Heart Foundation   (United States)

^b UNIVERSITY OF MILAN   (Italy)

^c SAN FILIPPO NERI HOSPITAL   (Italy)

^d SAN BORTOLO HOSPITAL   (Italy)

^e Ospedale Civile   (Italy)

^f International Renal Research Institute   (Italy)

Author keywords

Acute kidney injury; Cardio renal syndrome; Fluid overload; Heart failure; Hemodialysis; Hemofiltration; Oliguria; Refractory edema; Ultrafiltration

Indexed keywords

AMINO TERMINAL PRO BRAIN NATRIURETIC PEPTIDE; DIURETIC AGENT; KIDNEY INJURY MOLECULE 1; NATRIURETIC FACTOR; NEUROHORMONE; NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN;

ACUTE HEART FAILURE; ARTICLE; BLOOD FLOW; BLOOD VISCOSITY; BLOOD VOLUME; CARDIORENAL SYNDROME; CLINICAL EFFECTIVENESS; COMPARATIVE STUDY; DIALYSIS; EXTRACOPOREAL ULTRAFILTRATION; HEART FAILURE; HEMOFILTRATION; HORMONE BLOOD LEVEL; HUMAN; PATIENT MONITORING; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; RENAL REPLACEMENT THERAPY; SAFETY; TREATMENT RESPONSE; ULTRAFILTRATION;

CARDIO-RENAL SYNDROME; DIURETICS; HEART FAILURE; HEMODIAFILTRATION; HEMOFILTRATION; HUMANS;

EID: 84857438878     PISSN: 02709295     EISSN: 15584488     Source Type: Journal    
DOI: 10.1016/j.semnephrol.2011.11.013     Document Type: Article

References (111)

1. Lloyd-Jones D., Adams R.J., Brown T.M., et al. Heart disease and stroke statistics-2010 update. A report from the American Heart Association statistics. Circulation 2010, 121:e46-e215.
2. Adams K.F., Fonarow G.C., Emerman C.L., et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J 2005, 149:209-216.
3. Jain P., Massie B.M., Gattis W.A., et al. Current medical treatment for exacerbation of chronic heart failure resulting in hospitalization. Am Heart J 2003, 145:S3-S17.
4. Drazner M.H., Rame J.E., Stevenson L.W., Dries D.L. Prognostic importance of elevated jugular venous pressure and a third heart sound in patients with heart failure. N Engl J Med 2001, 345:574-581.
5. Androne A.S., Katz S.D., Lund L., et al. Hemodilution is common in patients with advanced heart failure. Circulation 2003, 107:226-229.
6. Heywood J.T., Fonarow G.C., Costanzo M.R., Mathur V.S., Wigneswaran J.R., Wynne J. High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database. J Card Fail 2007, 13:422-430.
7. Ronco C., Haapio M., House A., Anavekar N., Bellomo R. Cardio-Renal syndrome. J Am Coll Cardiol 2008, 52:1527-1539.
8. Felker G.M., Lee K.L., Bull D.A., et al. Diuretic strategies evaluation in patients with acute decompensated heart failure. N Engl J Med 2011, 364:797-805.
9. Silverstein M.E., Ford C.A., Lysaght M.J., Henderson L.W. Treatment of severe fluid overload by ultrafiltration. N Engl J Med 1974, 291:747-751.
10. Henderson L.W., Lilley J.J., Ford C.A., Stone R.A. Hemodiafiltration. J Dial 1977, 1:211-238.
11. Nalesso F., Garzotto F., Ronco C. Technical aspects of extracorporeal ultrafiltration: mechanisms, monitoring and dedicated technology. Contrib Nephrol 2010, 164:199-208.
12. Ricci Z., Bonello M., Salvatori G., Ratanarat R., Brendolan A., Dan M., et al. Continuous renal replacement technology: from adaptive technology and early dedicated machines towards flexible multipurpose machine platforms. Blood Purif 2004, 22:269-276.
13. Jaski B.E., Ha J., Denys B.G., Lamba S., Trupp R.J., Abraham W.T. Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients. J Card Fail 2003, 9:227-231.
14. Ronco C., Levin N.W. Mechanisms of solute transport in extracorporeal therapies. Contrib Nephrol 2005, 149:10-17.
15. Ronco C., Ricci Z., Brendolan A., Bellomo R., Bedogni F. Ultrafiltration in patients with hypervolemia and congestive heart failure. Blood Purif 2004, 22:150-163.
16. Ronco C., Clark W.R. Factors affecting hemodialysis and peritoneal dialysis efficiency. Semin Dialysis 2001, 14:257-262.
17. Ronco C., Ballestri M., Cappelli G. Dialysis membranes in convective treatments. Nephrol Dial Transplant 2000, 15(Suppl 2):31-36.
18. Ronco C., Breuer B., Bowry S.K. Hemodialysis membranes for high-volume hemodialytic therapies: the application of nanotechnology. Hemodial Int 2006, 10:S48-S50.
19. Ronco C., Crepaldi C., Brendolan A., Bragantini L., D'Intini V., Inguaggiato P., et al. Evolution of synthetic membranes for blood purification: the case of the Polyflux family. Nephrol Dial Transplant 2003, 18:10-20.
20. Clark W.R., Gao D., Ronco C. Membranes for dialysis. Composition, structure and function. Contrib Nephrol 2002, 137:70-77.
21. Ronco C. Hemodiafiltration: evolution of a technique towards better dialysis care. Contrib Nephrol 2011, 168:19-27.
22. Ronco C., Brendolan A., Crepaldi C., Rodighiero M., Scabardi M. Blood and dialysate flow distributions in hollow-fiber hemodialyzers analyzed by computerized helical scanning technique. J Am Soc Nephrol 2002, 13:S53-S61.
23. Ronco C., Bowry S.K., Brendolan A., Crepaldi C., Soffiati G., Fortunato A., et al. Hemodialyzer: from macro-design to membrane nanostructure; the case of the FX-class of hemodialyzers. Kidney Int 2002, 61:S126-S142.
24. Clark W.R., Hamburger R.J., Lysaght M.J. Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis. Kidney Int 1999, 56:2005-2015.
25. Ronco C., Ghezzi P.M., Metry G., Spittle M., Brendolan A., Rodighiero M.P., et al. Effects of hematocrit and blood flow distribution on solute clearance in hollow-fiber hemodialyzers. Nephron 2001, 89:243-250.
26. Kim J.C., Kim J.H., Sung J., Kim H.C., Kang E., Lee S.H., et al. Effects of arterial port design on blood flow distribution in hemodialyzers. Blood Purif 2009, 28:260-267.
27. Ronco C., Brendolan A., Lupi A., Metry G. Effects of a reduced inner diameter of hollow fibers in hemodialyzers. Kidney Int 2000, 58:809-817.
28. Fiore G., Guadagni G., Lupi A., Ricci Z., Ronco C. A new semiempirical mathematical model for prediction of internal filtration in hollow fiber hemodialyzers. Blood Purif 2006, 24:555-568.
29. Ethier J., Mendelssohn D.C., Elder S.J., Hasegawa T., Akizawa T., Akiba T., et al. Vascular access use and outcomes: an international perspective from the Dialysis Outcomes and Practice Patterns Study. Nephrol Dial Transplant 2008, 23:3219-3226.
30. Bonello M., Levin N.W., Ronco C. History and evolution of the vascular access for hemodialysis. Contrib Nephrol 2004, 142:1-13.
31. De Maria E., Pignatti F., Patrizi G., Benenati P.M., Ricci S., Cappelli S. Ultrafiltration for the treatment of diuretic-resistant, recurrent, acute decompensated heart failure: experience in a single center. J Cardiovasc Med (Hagerstown) 2010, 11:599-604.
32. Kroop I.G. America's initial application of the Kolff artificial kidney. Hemodial Int 2010, 14:346-347.
33. Bellomo R., Ronco C., Metha R. Nomenclature for continuous renal replacement therapies. Am J Kidney Dis 1996, 28:S2-S7.
34. Mehrotra R., Bellomo R., Ronco C. Ultrafiltration in congestive heart failure. Cardiology 2001, 96:121-126.
35. Clark W.R., Paganini E., Weinstein D., Bartlett R., Sheinfeld G., Ronco C. Extracorporeal ultrafiltration for acute exacerbation of chronic heart failure: report from the acute dialysis quality initiative. Int J Artif Organs 2005, 28:466-476.
36. Ronco C., Bellomo R. Continuous renal replacement therapies: the need for a standard nomenclature. Contrib Nephrol 1995, 116:28-33.
37. Ronco C., Bellomo R. Principles of solute clearance during continuous renal replacement therapy. Critical care nephrology 1998, 1213-1222. Kluwer Academic Publishers. C. Ronco, R. Bellomo (Eds.).
38. Clark W.R., Macias W.L., Molitoris B.A., et al. Plasma protein adsorption to highly permeable hemodialysis membranes. Kidney Int 1995, 48:481-488.
39. Ward R.A., Ronco C. Improvements in technology: a path to safer and more effective hemodialysis. Blood Purif 2009, 27:6-10.
40. Boyle A Ultrafiltration for acute decompensated heart failure. Expert Rev Med Devices 2005, 2:689-697.
41. Dahle T.G., Sobotka P.A., Boyle A.J. A practical guide to ultrafiltration in acute decompensated heart failure. Congest Heart Fail 2008, 14:83-88.
42. Cerda J., Sheinfeld G., Ronco C. Fluid overload in critically ill patients with acute kidney injury. Blood Purif 2010, 29:11-18.
43. Jaeger J.Q., Mehta R.L. Assessment of dry weight in hemodialysis: an overview. J Am Soc Nephrol 1999, 10:392-403.
44. Mehta R.L. Fluid management in CRRT. Contrib Nephrol 2001, 132:335-348.
45. Maisel A.S., Krishnaswamy P., Nowak R.M., et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002, 347:161-167.
46. Maisel A., Hollander J.E., Guss D., et al. Primary results of the rapid emergency department heart failure outpatient trial (REDHOT): a multicenter study of B-type natriuretic peptide levels, emergency department decision making, and outcomes in patients presenting with shortness of breath. J Am Coll Cardiol 2004, 44:1328-1333.
47. Mueller C., Schoeler A., Laule-Kilian K., et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 2004, 350:647-654.
48. Januzzi J.L., Camargo C.A., Anwaruddin S., et al. The N-terminal pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. J Am Coll Cardiol 2005, 95:948-954.
49. Maisel A.S. Use of BNP levels in monitoring hospitalized heart failure patients with heart failure. Heart Fail Rev 2003, 8:339-344.
50. O'Hanlon R., O'Shea P., Ledwidge M., O'Loughlin C., Lange S., Conlon C., et al. The biologic variability of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in stable heart failure patients. J Card Fail 2007, 13:50-55.
51. Rehman S.U., Januzzi J.L. Natriuretic peptide guided heart failure management. Compr Ther 2008, 34:32-40.
52. Iwanaga Y., Nishi I., Furuichi S., Noguchi T., Sase K., Kihara Y., et al. B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: comparison between systolic and diastolic heart failure. J Am Coll Cardiol 2006, 47:742-748.
53. Troughton R.W., Prior D.L., Pereira J.J., et al. Plasma B-type natriuretic peptide levels in systolic heart failure: importance of left ventricular diastolic function and right ventricular systolic function. J Am Coll Cardiol 2004, 43:416-422.
54. Kazanegra R., Cheng V., Garcia A., Krishnaswamy P., Gardetto N., Clopton P., et al. A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study. J Card Fail 2001, 7:21-29. 5.
55. Bettencourt P., Ferreira S., Azevedo A., et al. Preliminary data on the potential usefulness of B-type natriuretic peptide levels in predicting outcome after hospital discharge in patients with heart failure. Am J Med. 2002, 113:215-219.
56. Cioffi G., Tarantini L., Stefenelli C., et al. Changes in plasma N-terminal proBNP levels and ventricular filling pressures during intensive unloading therapy in elderly with decompensated congestive heart failure and preserved left ventricular systolic function. J Card Fail 2006, 12:608-615.
57. Di Somma S., Mgrini L., Mazzone M., et al. Decrease in NTproBNP plasma levels indicates clinical improvement of acute decompensated heart failure. Am J Emerg Med 2007, 25:335-339.
58. Yasumura Y., Miyatake K., Okamoto H., et al. Rationale for the use of combination angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker therapy in heart failure. Circ J 2004, 68:361-366.
59. Anand I.S., Fisher L.D., Chiang Y.T., et al. Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation 2003, 107:1278-1283.
60. Davis M.E., Richards M., Nicholls M.G., et al. Introduction of metoprolol increases plasma B-type cardiac natriuretic peptides in mild, stable heart failure. Circulation 2006, 113:977-985.
61. Richards A.M., Doughty R., Nicholls M.G., et al. Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction. Australia-New Zealand Heart Failure Group. J Am Coll Cardiol 2001, 37:1781-1787.
62. Anwaruddin A., Lloyd-Jones D.M., Baggish A., et al. Renal function, congestive heart failure, and amino-terminal pro-brain natriuretic peptide. J Am Coll Cardiol 2006, 48:1060-1061.
63. McCullough P.A., Duc P., Omland T., et al. B-type natriuretic peptide and renal function in the diagnosis of heart failure: an analysis from the Breathing Not Properly Multinational Study. Am J Kidney Dis 2003, 41:571-579.
64. Tapolyai M., Uysal A., Maeweathers G., et al. B-type natriuretic peptide-directed ultrafiltration improves care in acutely hospitalized dialysis patients. Congest Heart Fail 2000, 15:131-135.
65. Ronco C. Cardio-renal syndromes: from foggy bottoms to sunny hills. Heart Fail Rev. [cited 2011 Jan 23]. PubMed PMID: 21259069.
66. Haapio M, House AA, de Cal M, Cruz DN, Lentini P, Giavarina D, et al. Heart-kidney biomarkers in patients undergoing cardiac stress testing. Int J Nephrol. [cited 2010 Oct 20]. PubMed PMID: 21151536; PubMed Central PMCID: PMC2989651.
67. Ronco C., Brendolan A., Bellomo R. On-line monitoring in continuous renal replacement therapies. Kidney Int 1999, 56(Suppl 72):S8-S14.
68. Piccoli A. Whole body-single frequency bioimpedance. Contrib Nephrol 2005, 149:150-161.
69. Aspromonte N, Cruz DN, Valle R, Ronco C. Management and monitoring of haemodynamic complications in acute heart failure. Heart Fail Rev. [cited 2011 Feb 8]. PubMed PMID: 21301959.
70. Valle R., Aspromonte N., Ronco C. Optimizing Fluid Management in patients with Acute Decompensated Heart Failure (ADHF): the emerging role of combined measurement of body hydration status and brain natriuretic peptide (BNP) levels. Heart Fail 2011, In press.
71. House AA, Haapio M, Lentini P, Bobek I, de Cal M, Cruz DN, et al. Volume assessment in mechanically ventilated critical care patients using bioimpedance vectorial analysis, brain natriuretic peptide, and central venous pressure. Int J Nephrol. [cited 2010 Dec 2]. PubMed PMID: 21151535; PubMed Central PMCID: PMC2997502.
72. Bonello M., House A.A., Cruz D., Asuman Y., Andrikos E., Petras D., et al. Integration of blood volume, blood pressure, heart rare and bioimpedance monitoring for the achievement of optimal dry body weight during chronic hemodialysis. Int J Artif Organs 2007, 30:1098-1108.
73. Ronco C., Bellomo R. Continuous versus intermittent renal replacement therapy in the treatment of acute renal failure. Nephrol Dial Transplant 1998, 13:79-85.
74. Bellomo R., Ronco C. Acute renal failure in the ICU: adequacy of dialysis and the case for continuous therapies. Nephrol Dial Transplant 1996, 11:424-428.
75. Salvatori G., Ronco F., Bonello M., Bottero M. Management of fluid overload in congestive heart failure: learning from a case report. Int J Artif Organs 2006, 29:187-196.
76. Bellomo R., Palevsky P.M., Bagshaw S.M., Gibney N., McAlister F.A., Honore P.M., et al. Recent trials in critical care nephrology. Contrib Nephrol 2010, 165:299-309.
77. Bellomo R., Cass A., Cole L., Finfer S., Gallagher M., Lo S., et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 2009, 361:1627-1638. RENAL Replacement Therapy Study Investigators.
78. Palevsky P.M., Zhang J.H., O'Connor T.Z., Chertow G.M., Crowley S.T., Choudhury D., et al. Intensity of renal support in critically ill patients with acute kidney injury [Erratum in N Engl J Med. 2009;361:2391.]. N Engl J Med 2008, 359:7-20. VA/NIH Acute Renal Failure Trial Network.
79. Asaba H., Bergstrom J., Furst P., et al. Treatment of diuretic-resistant fluid retention with ultrafiltration. Acta Med Scand 1978, 204:145-149.
80. Fauchald P., Forfang K., Amlie J. An evaluation of ultrafiltration as treatment of therapy-resistant cardiac edema. Acta Med Scand 1986, 219:47-52.
81. Donato L., Biagini A., Contini C., et al. Treatment of end-stage congestive heart failure by extracorporeal ultrafiltration. Am J Cardiol 1987, 59:379-380.
82. Rimondini A., Cipolla C.M., Della Bella P., et al. Hemofiltration as short-term treatment for refractory congestive heart failure. Am J Med 1987, 83:43-48.
83. Di Leo M., Pacitti A., Bergerone S., et al. Ultrafiltration in the treatment of refractory congestive heart failure. Clin Cardiol 1988, 11:449-452.
84. Simpson I.A., Simpson K., Rae A.P., et al. Ultrafiltration in diuretic resistant heart failure. Renal Fail 1987, 10:115-119.
85. Akiba T., Taniguchi K., Marumo F., Matsuda O., et al. Clinical significance of renal hemodynamics in severe congestive heart failure: responsiveness to ultrafiltration therapies. Jap Circ J 1989, 53:191-196.
86. Cipolla C.M., Grazi S., Rimondini A., et al. Changes in circulating norepinephrine with hemofiltration in advanced heart failure. Am J Cardiol 1990, 66:987-994.
87. Marenzi G., Grazi S., Giraldi F., et al. Interrelation of humoral factors, hemodynamics, and fluid and salt metabolism in congestive heart failure: effects of extracorporeal ultrafiltration. Am J Med 1993, 94:49-56.
88. Pepi M., Marenzi G., Agostoni P.G., 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.
89. Agostoni P.G., Marenzi G.C., Pepi M., et al. Isolated ultrafiltration in moderate congestive heart failure. J Am Coll Cardiol 1993, 21:424-431.
90. Marenzi C.G., Lauri G., Assanelli E., et al. Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure. J Am Coll Cardiol 2001, 38:963-968.
91. Agostoni P.G., Marenzi G.C., Lauri G.F., 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.
92. Costanzo M.R., Saltzberg M., O'Sullivan J., Sobotka P. Early ultrafiltration in patients with decompensated heart failure and diuretic resistance. J Am Coll Cardiol 2005, 4611:2047-2051.
93. Bart B.A., Boyle A., Bank A.J., et al. Randomized controlled trial of ultrafiltration versus usual care for hospitalized patients with heart failure: relief for acutely fluid overloaded patients with decompensated congestive heart failure. J Am Coll Cardiol 2005, 46:2043-2046.
94. Costanzo M.R., Guglin M.E., Saltzberg M.T., et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol 2007, 49:675-683.
95. Costanzo M.R., Saltzberg M.T., Jessup M., et al. Ultrafiltration is associated with fewer re-hospitalizations than continuous diuretic infusion in patients with decompensated heart failure: results from UNLOAD. J Cardiac Fail 2010, 16:277-284.
96. Ali S.S., Olinger C.C., Sobotka P.A., et al. Loop diuretics can cause clinical natriuretic failure: a prescription for volume expansion. Congest Heart Fail 2009, 15:1-4.
97. Konstam M.A., Gheorghiade M., Burnett J.C., et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure. The EVEREST outcome trial. JAMA 2007, 297:1319-1331. Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) Investigators.
98. --cotransporter abundance: role of aldosterone. J Am Soc Nephrol 2001, 12:1335-1341.
99. He X.R., Greenberg S., Briggs J., Schnermann J. Effects of furosemide and verapamil on the NaCl dependency of macula densa-mediated secretion. Hypertension 1995, 26:137-142.
100. Nielsen S., Knepper M., Kwon T., et al. Regulation of water balance. Diseases of the kidney and urinary tract 2001, 109-134. Lippincott Williams and Wilkins, New York. 7th ed. R.W. Schrier (Ed.).
101. Fang J., Mensah G.A., Croft J.B., Keenan N.L. Heart failure-related hospitalization in the U.S., 1979 to 2004. J Am Coll Cardiol 2008, 52:428-434.
102. Rogers H.L., Marshall J., Bock J., Dowling T.C., Feller E., Robinson S., et al. A randomized, controlled trial of the renal effects of ultrafiltration as compared to furosemide in patients with acute decompensated heart failure. J Card Fail 2008, 14:1-5.
103. Jessup M., Abraham W.T., Casey D.E., et al. 2009 focused update: ACCF/AHA 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. Circulation 2009, 119:1977-2016.
104. Howlett J.G., McKelvie R.S., Costigan J., et al. The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs. Can J Cardiol 2010, 26:185-202.
105. Dickstein K., Cohen-Solal A., Filippatos G., et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Eur Heart J 2008, 29:2388-2442.
106. Gheorghiade M., Follath F., Ponikowski P., et al. Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine. Eur J Heart Fail 2010, 12:423-433.
107. Bart B.A. Ultrafiltration is the only rational initial treatment of volume overload in decompensated heart failure. Circ Heart Fail 2009, 2:499-504.
108. Bart B.A. Ultrafiltration is the only rational initial treatment of volume overload in decompensated heart failure. Circ Heart Fail 2009, 2:499-504.
109. Ricci Z., Ronco C., D'amico G., et al. Practice patterns in the management of acute renal failure in the critically ill patient: an international survey. Nephrol Dial Transplant 2006, 21:690-696.
110. Ronco C., Davenport A., Gura V. The future of the artificial kidney: moving towards wearable and miniaturized devices. Nefrologia 2011, 31:9-16.
111. Ronco C., Davenport A., Gura V. A wearable artificial kidney: dream or reality?. Nat Clin Pract Nephrol 2008, 4:604-605.