Inflammatory Biomarkers in Refractory Congestive Heart Failure Patients Treated with Peritoneal Dialysis

Abstract

Proinflammatory cytokines play a pathogenic role in congestive heart failure. In this study, the effect of peritoneal dialysis treatment on inflammatory cytokines levels in refractory congestive heart failure patients was investigated. During the treatment, the patients reached a well-tolerated edema-free state and demonstrated significant improvement in NYHA functional class. Brain natriuretic peptide decreased significantly after 3 months of treatment and remained stable at 6 months. C-reactive protein, a plasma marker of inflammation, decreased significantly following the treatment. Circulating inflammatory cytokines TNF-α and IL-6 decreased significantly after 3 months of peritoneal dialysis treatment and remained low at 6 months. The reduction in circulating inflammatory cytokines levels may be partly responsible for the efficacy of peritoneal dialysis for refractory congestive heart failure.

The Behavior of the Type of Peritoneal Transport in the Inflammatory and Oxidative Status in Adults Under Peritoneal Dialysis

“…Systemic pro-inflammatory cytokines is a significant risk factor suggestive of infection in patients with PD (28). However, recently it was reported that circulating pro-inflammatory cytokines TNF-α and IL-6 decreased significantly after 3 months of PD and remained low at 6 months of follow-up in patients with heart failure undergoing PD due to overflow (29). The patients included in the study did not have heart failure, but the information could partially explain the behavior of the pro-inflammatory cytokines in the included patients.…”

Peritoneal dialysis in heart failure: focus on kidney and ventricular dysfunction

“…These factors have a molecular weight that ranges from 500 to 30,000 Da, and the peritoneum is permeable to these solutes. Their removal from the blood positively affects the half-life of myocardial cells [55,56]. Moreover, PD may improve the sensitivity to HF treatment.…”

Congestive heart failure treated with peritoneal dialysis or hemodialysis: Typical patient profile and outcomes in real‐world setting

“…Treatment of systemic congestion is one of the most difficult challenges in the management of severe CHF, particularly in patients with diuretic resistance. Peritoneal dialysis (PD) provides daily fluid removal and has several advantages compared with ultrafiltration through hemodialysis (HD): minimal impact on hemodynamics, slower decline in residual kidney function, sodium sieving with maintenance of normonatremia, possibility of draining of ascites, avoidance of risks related to a vascular access and improvement of systemic inflammatory state 3‐5 . It was demonstrated that in severe CHF patients PD improves functional status and quality of life, reduces hospitalisation rate and may even decrease mortality rate 6‐9 .…”

“…avoidance of risks related to a vascular access and improvement of systemic inflammatory state. [3][4][5] It was demonstrated that in severe CHF patients PD improves functional status and quality of life, reduces hospitalisation rate and may even decrease mortality rate. [6][7][8][9] Moreover, PD is associated with a higher risk of insulin resistance, dyslipidemia and metabolic syndrome, while in HD there is better control of sodium and water balance.…”