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ICD-9: 99.78

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


Aquapheresis is used to treat a condition called fluid overload or hypervolemia. Fluid overload can be caused by many reasons, including heart failure, liver cirrhosis, hypertension and certain kidney diseases. Fluid overload can also be experienced after certain surgical operations. Congestive heart failure is the most common reason for fluid overload.

How it works[edit]

  • Blood containing excess salt and water is withdrawn from a patient using peripheral or central venous catheters and passed through a special filter. Using a form of ultrafiltration, the filter separates the excess salt and water from the blood and the blood is returned to the patient while the fluid is collected in a bag for later disposal.
  • Anti-coagulation therapy is often used with aquapheresis to prevent blood from clotting the ultrafiltration filter. Patients must discontinue any anticoagulant medications before starting aquapheresis so they can be placed on intravenous Heparin therapy. Once the Heparin therapy is initiated, the patient's PTT (partial thromboplastin time) levels will be monitored closely per hospital protocol to prevent excessive anti-coagulation. If a patient is allergic to Heparin or has a condition known as Heparin-induced Thrombocytopenia (HIT), an alternative intravenous anti-coagulate may be used.
  • The blood is outside the body for less than a minute and the total amount of blood is 33 milliliters (2.5 tablespoons). It is thus an extracorporeal therapy.
  • Up to a 500 milliliter (1 pint) of excess fluid can be removed per hour. The average removal rate is 250 milliliter (1/2 pint) per hour.
  • The fluid removed is isotonic to blood and therefore electrolyte balance is maintained throughout therapy and up to 3.2 grams of sodium per liter can be removed.
  • Aquapheresis therapy is delivered by three basic components: a console (the machine with two pumps), the blood filter circuit, and the venous catheter(s).

See also[edit]


  • Costanzo MR, Guglin ME, Saltzberg MT, et al. (Feb 2007). "Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure". J Am Coll Cardiol 49 (6): 675–83. doi:10.1016/j.jacc.2006.07.073. PMID 17291932. 
  • Costanzo MR, Guglin ME, Saltzberg MT, et al. (2010). "Ultrafiltration is Associated With Fewer Rehospitalizations than Continuous Diuretic Infusion in Patients With Decompensated Heart Failure: Results From UNLOAD". J Card Fail 16 (4): 277–84. doi:10.1016/j.cardfail.2009.12.009. PMID 20350693. 
  • Costanzo MR, Saltzberg M, O'Sullivan J, Sobotka P (Dec 2005). "Early ultrafiltration in patients with decompensated heart failure and diuretic resistance". J Am Coll Cardiol 46 (11): 2047–51. doi:10.1016/j.jacc.2005.05.099. PMID 16325040. 
  • Bart BA, Boyle A, Bank AJ, et al. (Dec 2005). "Ultrafiltration versus usual care for hospitalized patients with heart failure: the Relief for Acutely Fluid-Overloaded Patients With Decompensated Congestive Heart Failure (RAPID-CHF) trial". J Am Coll Cardiol 46 (11): 2043–6. doi:10.1016/j.jacc.2005.05.098. PMID 16325039. 
  • Jaski BE, Ha J, Denys BG, Lamba S, Trupp RJ, Abraham WT (Jun 2003). "Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients". Journal of Cardiac Failure 9 (3): 227–31. doi:10.1054/jcaf.2003.28. PMID 12815573. 
  • Agostoni P, Marenzi G, Lauri G, et al. (Mar 1994). "Sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency: failure of furosemide to provide the same result". Am J Med. 96 (3): 191–9. doi:10.1016/0002-9343(94)90142-2. PMID 8154506. 

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