Diuretic treatment using the RenalGuard® system in patients hospitalized due to acute decompensated heart failure and characterization of the profile of patients with good and poor response to treatment - preliminary study.

Abstract

The aim of the study was to analyze the potential relationship between the diuretic response, the clinical profile and the concentrations of selected biochemical markers and to identify a group of patients who will benefit from a new form of therapy combining standard diuretic therapy with the use of a RenalGuard® system. This is a retrospective study of 19 patients (mean age 67 ± 10 years, 95% men) hospitalized due to acute decompensated heart failure (ADHF, NYHA class III-IV, BP 125 ± 14/73 ± 16 mmHg, eGFR 58 ± 24) with persistent overhydration despite standard therapy. A targeted comparative analysis of selected clinical and biochemical parameters was performed to determine the parameters associated with a better diuretic response [good diuretic responders (GDR) group]. The good diuretic responders group had significantly lower levels of creatinine (1.23 ± 0.4 vs. 1.69 ± 0.35, p = 0.025) magnesium 0.70 ± 0.14 vs. 0.83 ± 0.09, p = 0.030) and blood urea nitrogen (BUN, 28 ± 11 vs. 39 ± 10, p = 0.045). Additionally, in GDR group a statistically significant greater ability to dilute urine in the 12th and 24th hour of therapy was found. The results of the study indicate the potential use of the RenalGuard® system in combination with standard intravenous diuretic therapy for controlled dehydration in the treatment of a selected group of patients with ADHF. It is advisable to identify the detailed mechanisms of GDR and characterize this group of patients more precisely.