Ultrafiltration Versus Medical Therapies in the Management of the Cardio Renal Syndrome

Inclusion Criteria

• •Severe heart failure with recurring congestive symptoms and at least one the following criteria :
• •* At least 2 hospitalization \> 24 hours for congestive symptoms among the 12 months before the inclusion, whose latest one was in the 6 months before the inclusion
• •* Persistent congestive symptoms throughout 30 days (case history) before the randomization: dyspnea NYHA III or IV, lower limbs edema and/or ascites.
• •Diuretic treatment with at least 250mg furosemide per day (or 6mg bumetanide)during at least 1 month
• •Cardiac medical treatment enhanced by the European cardiology society guidance (except intolerance, and/or contraindication) and according to patient cardiologist.
• •Non terminal kidney disease or failure : estimated glomerular filtration rate (GFR) (CKD-Epi formula) between 20 and 90 mL/min/1.73m² (or GFR estimated between 60 and 90 mL/min/1.73m² with proteinuria and/or hematuria) and urea rate under 50mmol/L