Naturally Controlled Decongestion Using Renal Independent System in ADHF Patients, a European Registry

Inclusion Criteria: * Subject that was hospitalized with fluid overload and a history of chronic heart failure and CKD stages 1-4 * Subject has composite congestion score ≥3. * Baseline systolic blood pressure at rest of ≥100mmHg. * Subject is capable of meeting the following study requirements: * For patients with BMI \<30 kg/m2: baseline NT-pro BNP\>1,600 pg/ml * For patients with BMI \>30 kg/m2: baseline NT-pro BNP \>800 pg/ml * For patients with rate-controlled persistent or permanent AF: NT-pro BNP \>2,400 pg/ml. * Subject successfully completes 2-4 hours of run-in acclimation session * Minimal sweat rate in the last hour of run-in acclimatization of 130gr/hours Exclusion Criteria: * Subject is enrolled to another clinical investigation that might interfere with this study. * Baseline systolic blood pressure \<100 mm Hg * Subject considered to be in the acute worsening of the heart failure: Requiring ventilation, mechanical support or is clinically unstable requiring pressors, deterioration triggered by arrythmia, infection or other medical condition unrelated to fluid overload. * Subject has any known lower body skin problems (open wounds, ulcers) * Subject with severe peripheral arterial disease * Subject is pregnant or planning to become pregnant within the study period, or lactating mothers. * End-stage renal disease (eGFR\<15 ml/min/1.73 m2) or requiring dialysis. * Inability or unwillingness to comply with the study requirements. * History of heart transplant or actively listed for heart transplant or Left Ventricular Assist Device (LVAD). * Implanted left ventricular assist device or implant anticipated \<3 months. * Malignancy or other noncardiac condition limiting life expectancy to \<12 months.