Clinical Study On The Recovery Of Diuretic Sensitivity By Ultrafiltration In Patients With Diuretic Resistant Heart Failure

Background: Patients with heart failure need diuretics for the treatment of respiratory difficulties,severe edema and other symptoms caused by excessive volume load,but some patients have diuretic resistance in the process of long-term and large amount of diuretic treatment,resulting in repeated and long-term hospitalization without effective relief of volume load.Ultrafiltration in the treatment of diuretic resistant patients can effectively solve the problem of volume overload in these patients,reduce the readmission rate and restore their sensitivity to diuretics.Objective: This study mainly describes the current situation of the occurrence of diuretic hypersensitivity in ultrafiltration therapy and explores the possible reasons for its occurrence.Research method: A study was conducted on patients with diuretic resistance who received ultrafiltration treatment in the department of cardiology of the friendship hospital and subei people's hospital of Jiangsu province from January 2017 to December 2019.Data of patients' urine volume,weight change,clinical signs,laboratory indicators,patients' recovery of diuretic sensitivity time of diuretics,recovery effect of diuretic sensitivity,and adverse events in ultrafiltration at 24 hours before and after ultrafiltration were collected,sorted out and counted.Consequence: 1.Among the 36 patients with ultrafiltration,32 were sensitized by diuretics,21 were effective,11 were effective,and 4 were ineffective.The total incidence of sensitization by diuretics was 88.8%.2.Recovery time of patients' continuous diuretic sensitivity after ultrafiltration: the average duration was 46.5 days,with the shortest duration of 7 days and the longest duration of 86 days.3..The clinical signs of the patients before ultrafiltration,such as lung rhombus,pleural effusion,and bilateral lower limb edema,were significantly improved compared with those before ultrafiltration(p < 0.05).4.There were significant changes in urine volume and body weight after ultrafiltration(p < 0.05).5.BNP in ultrafiltration patients was significantly lower than before,which was statistically significant.Although the trend of LVEF increased,the difference was not statistically significant.6.There was no significant change in renal function,electrolyte and blood routine during ultrafiltration.7.Bleeding events occurred in 3 patients with ultrafiltration,and the incidence of adverse events was 9%.Conclusion: 1.Ultrafiltration therapy can restore the sensitivity of diuretic resistant heart failure patients to diuretic,and the average duration of the sensitivity is 46.5 days.2.Ultrafiltration treatment can significantly reduce BNP in patients with heart failure,with no significant change in LVEF.3.Ultrafiltration had no significant effect on renal function,electrolyte,blood routine and blood pressure of the patients.4.Ultrafiltration can significantly improve the clinical symptoms of patients,and the incidence of adverse events in the whole ultrafiltration treatment is 9%.