Age

18–any

Sex

ALL

Healthy volunteers

Not accepted

Adults over 18 years old with End-Stage Renal Disease on hemodialysis for at least 3 months.
Admitted to the hospital requiring mechanical fluid removal for acute fluid overload (first in-hospital session).
Clear ultrasound evidence of severe intravascular congestion (such as diffuse B-lines in the lungs or altered VExUS vascular flow patterns).
Hemodynamically stable with a baseline blood pressure of at least 120/80 mmHg.

Baseline low blood pressure (\<100/60 mmHg) or active shock (cardiogenic, septic, or distributive).
Acute coronary syndrome (heart attack), severe heart valve disease, or severe fluid around the heart.
Known chronic lung disease.
Pregnancy.

The FILTRATE Trial: High-Rate Ultrafiltration for Intravascular Congestion