If you’re suffering from fluid overload, your healthcare provider may prescribe the following to remove your excess sodium and water:

• Low salt diet (limits the amount of salt/sodium that you take in)
• Fluid restriction (limits the amount of liquids you take in)
• Diuretic drugs, e.g. water pills (increases urine production)
• Aquapheresis Therapy (mechanically filters the excess from your blood)

Many patients are helped with diuretic drugs and achieve and maintain normal dry weights. However, these diuretic drugs don’t always work or they temporarily stop working, and patients may be hospitalized to adjust or change their medications and/or to remove extra fluid by other means.

For example, approximately 50% of hospitalized heart failure patients achieve fluid and weight reduction with diuretics. The other 50% do not. Up to 30% of fluid overload patients suffer from diuretic resistance. This means that their kidneys for one reason or another, are not responding to the diuretic drugs as they should. This condition can last for a short amount of time (acute) or prolonged (chronic).

Diuretic drugs are considered the standard of care. Until recently, not much data existed about their long term effects. Recently however, significant clinical data has been published to highlight diuretic drugs overall effects and as with any treatment option, the positives and the negatives should be discussed and known.

The Positives About Diuretics
– Induce urination and reduce total body volume in many patients 4,16
– Effective in reduction of symptomatic congestion 1,4,16

The Negative About Diuretics
– Reduced kidney function 7,8,9,14
– Activation of neurohormones 3,10
– Loss of electrolytes (e.g potassium, calcium) 12,17
– Reduced cardiac output 10,11
– Increased Total Systemic Vascular Resistance 11
– Increase risk for hospitalization for heart failure 15

The Really Negative About Diuretics
– Associated with enhanced morbidity (sickness) 2,15
– Associated with increased mortality (death) 2,5,6,13,15,18

Aquapheresis: A Non-Drug, Non-Diuretic Treatment Option for Fluid Overload:

Aquapheresis is a medical therapy designed to remove excess salt and water from the body safely, predictably, and effectively from patients suffering from fluid overload. It removes excess salt and water and helps to restore a patient’s fluid balance or euvolemia.

• To understand Aquapheresis better, go to
  "Aquapheresis and How It Works"
• To compare Aquapheresis with diuretic drugs in terms of fluid removed, time taken, and total sodium removed, go to "Volume Calculator".

Talk to Your Doctor and Demand The Best Care and Outcomes:

Learning about your disease and its symptoms is an important part of taking control of your health care. Read more, educate yourself and your healthcare provider on what you think and what's the latest in clinical data and technology. Talk to your doctor about what the best treatment options are for you and demand the best outcomes.

Sources:

1. Adhere National Benchmark Report, January 2001 to April 2006
2. Emerman JCF 2004;10(4):S116:368.
3. Bayliss, Br Heart J 1987;57:17-22.
4. Faris Int J Cardiol. 2002;82(2): 149-58.
5. Mehta JAMA 2002;288(20):2547-53.
6. Butler, Am Heart J 2004; 147:331-338.
7. Gottlieb JACC, 2000;35(1):56-59.
8. Brater DC NEJM 1998;339:387.
9. Firth Lancet 5/7/88.
10. Francis AIM 1985;103:1-6.
11. Ribboli Am J Physiol. 1994 Sep;267(3 Pt 2):H1054-61.
12. McCurley, JACC 2004;44(6):1301-1307.
13. Fonarow Am J Cardiol 2006;97:1759-1764.
14. Gottlieb Circ 2002;105:1348-1353.
15. Domanski JACC 2003;42:705-708.
16. Stampfer Circ 1968;37:900-911.
17. Laragh Hypert 2001;37:806-810.
18. Neuberg Am Heart J 2002;144:31-38.