Acute decompensated heart failure and fluid overload are the most common causes of hospitalization in heart failure patients, and often, they contribute to disease progression. Initial treatment encompasses intravenous diuretics although there might be a percentual of patients refractory to this pharmacological approach. New technologies have been developed to perform extracorporeal ultrafiltration in fluid overloaded patients. Current equipment allows to perform ultrafiltration in most hospital and acute care settings. Extracorporeal ultrafiltration is then prescribed and conducted by specialized teams, and fluid removal is planned to restore a status of hydration close to normal. Recent clinical trials and European and North American practice guidelines suggest that ultrafiltration is indicated for patients with refractory congestion not responding to medical therapy. Close interaction between nephrologists and cardiologists may be the key to a collaborative therapeutic effort in heart failure patients. Further studies are today suggesting that wearable technologies might become available soon to treat patients in ambulatory and de-hospitalized settings. These new technologies may help to cope with the increasing demand for the care of chronic heart failure patients. Herein, we provide a state-of-the-art review on extracorporeal ultrafiltration and describe the steps in the development of a new miniaturized system for ultrafiltration, called AD1 (Artificial Diuresis).

急性失代偿性心力衰竭和液体超负荷是心力衰竭患者住院的最常见原因，并且通常会导致疾病进展。初始治疗包括静脉注射利尿剂，尽管可能有一定比例的患者对该药理学方法无效。新技术已被开发用于对液体超负荷的患者进行体外超滤。目前的设备允许在大多数医院和急症护理环境中进行超滤。然后由专业团队规定并进行体外超滤，并计划去除液体以恢复接近正常的水合状态。最近的临床试验以及欧洲和北美的实践指南表明，超滤适用于对药物治疗无反应的顽固性充血患者。肾病专家和心脏病专家之间的密切互动可能是心力衰竭患者协作治疗的关键。今天的进一步研究表明，可穿戴技术可能很快就会用于在门诊和非住院环境中治疗患者。这些新技术可能有助于满足慢性心力衰竭患者日益增长的护理需求。在此，我们对体外超滤进行了最先进的回顾，并描述了一种新型微型超滤系统（称为 AD1（人工利尿））的开发步骤。