Reply: intravenous loop diuretics versus isolated ultrafiltration for chronic congestive heart failure: competition or integration?

摘要

The letter by Amico [1] re-proposes a very controversial topic, that is the comparison between intravenous (i.v.) loop diuretic therapy and isolated ultrafiltration in the chronic congestive heart failure (GHF) setting, which may appear an unequal competition at first sight. We are also of the opinion that ultrafiltration only allows the physician to instantaneously adjust the exact dosage of fluids which have to be removed with precision much higher than that attained by simply planning a scheduled course of i.v. loop diuretic therapy [2,3]. Nevertheless, no significant linear correlation has been documented up to now between net fluid removed by ultrafiltration or by diuretics and changes in serum creatinine [4].