Clinical and hemodynamic results of peritoneal dialysis for severe cardiac failure

Cairns, Kenneth B.; Porter, George A.; Kloster, Frank E.; Bristow, James; Griswold, Herbert E.

doi:10.1016/0002-8703(68)90198-1

Cited by 67 publications

(29 citation statements)

References 24 publications

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“…As expected, fluid removal results in a reduction of plasma volume [22, 23], an improvement in hyponatremia [23, 27]and a reduction in pulmonary capillary wedge pressure. Even though no consistent effects on cardiac output have been demonstrable [22, 23], an improvement in diuretic responsiveness has frequently been documented [22, 23, 28]. It is likely that this restoration of diuretic responsiveness is related to an improvement in renal hemodynamics; the use of PD results in an increase in inulin clearance, paraamino hippurate clearance and a reduction in the filtration fraction [28].…”

Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 68%

“…Since then, clinical experience with a total of 56 patients has been published in the English-language literature [16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28]. The reported rates of fluid removal in these publications are summarized in table 2.…”

Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 99%

“…The reported rates of fluid removal in these publications are summarized in table 2. Based upon these reports, it is obvious that the alleviation of symptoms of volume overload is readily obtainable using PD, and with the currently available PD solutions, fluid removal rates of 67–568 ml/h can be achieved [18, 19, 20, 21, 23, 24, 25, 28], a rate not dissimilar to that obtained with continuous extracorporeal therapies.…”

Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 99%

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Peritoneal Ultrafiltration for Chronic Congestive Heart Failure: Rationale, Evidence and Future

Mehrotra

Khanna

2001

Cardiology

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Peritoneal dialysis (PD) was the first dialytic therapy used to achieve euvolemia in individuals with refractory congestive heart failure. PD remains a viable therapy for the short-term management of refractory congestive heart failure, and fluid removal rates comparable to those obtained with the continuous extracorporeal therapies can be achieved. However, with advances in extracorporeal therapies, the role of PD in these situations is limited to those individuals in whom vascular access cannot be obtained or if extracorporeal therapies are not available. On the other hand, PD is the ultrafiltration therapy of choice for the long-term ambulatory management of individuals with refractory congestive heart failure, either as a palliative therapy or as a bridge to definitive surgery or transplantation. A reduction in hospitalization rates and an improvement in functional capacity can be expected under such circumstances; however, survival is unlikely to be affected.

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Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 68%

Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 99%

Section: Pd For Short-term Management Of Refractory Congestive Heart mentioning

confidence: 99%

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Peritoneal Ultrafiltration for Chronic Congestive Heart Failure: Rationale, Evidence and Future

Mehrotra

Khanna

2001

Cardiology

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“…In summary these reports demonstrated fl uid removal rate of 67-568ml/hour with improvement in symptoms in most of the patients. Fluid removal was associated with an improvement in plasma volume (25) and hyponatremia. The patient underwent a total of 8 treatments over a period of 2 years and eventually died in a car accident.…”

Section: Intermittent Pdmentioning

confidence: 93%

Peritoneal dialysis in congestive heart failure

Krishnan¹,

Oreopoulos²

2017

SAHJ

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Even in renal failure patients on PD, introduction of icodextrin has been shown to decrease extra cellular water and improve hemodynamics. Icodextrin offers several advantages:■ It offers more physiologic ultrafi ltration.■ Euvolemia can be maintained without additional dextrose exchanges.■ Single exchange is easy on lifestyle and decreases risk of touch contamination and hence incidence of peritonitis. Neither of the patients required hospitalization for either cardiac or dialysis related issues, as compared to multiple admissions in the preceding year. FUTURE PROSPECTS■ Comparison of PD versus standard therapy and ultrafi ltration devices to demonstrate survival benefi t with less morbidity and costs.■ Is there preservation of renal function with PD as compared to standard medical therapy? Will this delay the progression of heart failure by interrupting cardiorenal syndrome?■ What will be the effect of biocompatible PD solution with associated less infl ammation on heart failure pathogenesis?■ Large trials with long-term follow-up looking at the effect of PD on progression of heart failure.

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“…Patients likely to require only one or two dialyses are readily managed by PD. For instance, in severe intractable congestive heart failure, large amounts of extracellular fluid can be removed safely over a 24-to 36-hour PD without causing serious hypotension or cardiovascular complications [14,17,35], PD also may be the treatment of choice for intoxication with drugs such as diphenylhydantoin and glutethimide, in which a relatively low blood level and a high degree of tissue or protein binding favors prolonged slow dialysis, thus avoiding drug rebound. Although most drug intoxications can be managed conservatively, in very severe cases dialysis may shorten coma and be life saving.…”

Section: Indications For Peritonea! Dialysismentioning

confidence: 99%

Peritoneal Dialysis Today: A New Look

Tenckhoff¹

1974

Nephron

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Peritoneal dialysis, its indications and contraindications are reviewed in the light of recent technical developments and clinical experience with 69 patients on maintenance treatment. Protein depletion and peritonitis can no longer be considered inevitable endpoints of acute or chronic peritoneal dialysis. Based on an extensive experience in both hemodialysis and peritoneal dialysis, it is suggested that perhaps as many as 20–25% of patients in need of dialysis should preferentially receive peritoneal dialysis treatment.

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Clinical and hemodynamic results of peritoneal dialysis for severe cardiac failure

Cited by 67 publications

References 24 publications

Peritoneal Ultrafiltration for Chronic Congestive Heart Failure: Rationale, Evidence and Future

Peritoneal Ultrafiltration for Chronic Congestive Heart Failure: Rationale, Evidence and Future

Peritoneal dialysis in congestive heart failure

Peritoneal Dialysis Today: A New Look

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