Abstract: Objective To evaluate the effect of ultrafiltration (UF) and intravenous diuretics on patients with congestive heart failure. Methods PubMed, CBM and other databases were searched from inception to Nov. 2016 for randomized controlled trials that used diuretics as control group. Inclusion and exclusion criteria were defined. After quality assessment and data extraction the records were analyzed with Rev Man 5.3 software for mete-analysis. Results Eleven studies including 870 cases (n=434 in UF group, n=436 in diuretics group) were enrolled in this study. UF therapy led to greater weight loss (WMD=1.390, 95% CI 0.640～2.150, P <0.001), more fluid remove (WMD=1.220, 95% CI 0.490～1.960, P=0.001), and less rehospitalization rate (OR=0.600, 95% CI -0.430～0.840, P=0.003) as compared with the patients in diuretic group. However, there were no significant differences in mortality (OR=0.990, 95% CI 0.660～1.470, P=0.960), creatinine (WMD=0, 95% CI -0.250～0.250, P=0.980), LVEF (WMD=-0.020, 95% CI -0.070～0.020, P=0.280) and NT-ProBNP (WMD=2327.610, 95% CI -5215.360～560.130, P=0.110) between the two groups. No serious adverse events were reported in the two groups. Conclusion UF is more efficient and safer than diuretics for heart failure patients with fluid overload. Heart failure related rehospitalization rate was lower after UF. However, survival was similar between patients treated with UF and those with diuretics. Serious adverse events were not found in UF patients.

Key words:  congestive heart failure, Ultrafiltration, diuretcs, Meta-analysis