Effectiveness of Ultrafiltration in Treating People With Acute Decompensated Heart Failure and Cardiorenal Syndrome (The CARRESS Study)

Inclusion criteria: * age 18 or older * admitted to the hospital with a primary diagnosis of decompensated heart failure * onset of cardiorenal syndrome after hospitalization or pre-hospitalization * after hospitalization - onset of cardiorenal syndrome after hospitalization must occur within 10 days from the time of admission after receiving IV diuretics * pre-hospitalization - onset of cardiorenal syndrome pre-hospitalization must occur within 12 weeks of the index hospitalization in the setting of escalating doses of outpatient diuretics * persistent volume overload Exclusion criteria: * intravascular volume depletion based on investigator"s clinical assessment * acute coronary syndrome within 4 weeks * indication for hemodialysis * creatinine \> 3.5 mg per deciliter at admission to the hospital * systolic blood pressure \< 90 mmHg at the time of enrollment * alternative explanation for worsening renal function such as obstructive nephropathy,contrast induced nephropathy, acute tubular necrosis * Hematocrit \> 45% * poor venous access * clinical instability likely to require the addition of intravenous vasoactive drugs including vasodilators and/or inotropic agents * allergy or contraindications to the use of heparin * the use of iodinated radio contrast material in the last 72 hours or anticipated use of IV contrast during the current hospitalization * known bilateral renal artery stenosis * active myocarditis * hypertrophic obstructive cardiomyopathy * severe valvular…