Extracorporeal Ultrafiltration (UF) vs. Usual and Customary Care for Patients With Severe Heart Failure (HF)

Inclusion Criteria: * Admitted to Heart Failure Unit (H-22) with NYHA class III/IV HF and pulmonary artery catheter in situ * Left ventricular ejection fraction \<40% * Mean Pulmonary Artery Occlusion Pressure ≥20 mm Hg * Able to give informed consent Exclusion Criteria: * Currently on renal replacement therapy or determined to need renal replacement therapy at the time of enrollment * Estimated glomerular filtration rate (GFR) \<15 mL/min * Systolic blood pressure (SBP) \<80 mm Hg * Acute coronary syndrome * Hematocrit \>50% * Malignancy other than prostrate or skin * Chronic edematous states other than HF, including nephritic syndrome and cirrhosis * Chronic inflammatory or infectious condition * Pregnancy * Previous enrollment in this study * Expectation of need for heart transplantation or cardiac assist device within one week * Pulmonary failure requiring intubation and mechanical ventilation * Known or suspected hypersensitivity to dialysis membranes * Severe aortic stenosis or regurgitation * Severe mitral stenosis