Peritoneal dialysis in congestive heart failure

Krishnan, Abirami; Oreopoulos, Dimitrios G.

doi:10.24170/4-3-2086

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…[ 10 11 ] Whatever the cause, all heart failure patients eventually progress to a refractory stage characterized by worsening renal function and resistance to diuretic therapy with attending severe edema. [ 12 ] We studied the effect of peritoneal ultrafiltration in these patients with chronic refractory congestive cardiac failure.…”

Section: Discussionmentioning

confidence: 99%

Ultrafiltration by peritoneal route in refractory chronic congestive cardiac failure

2018

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Diuretics are the mainstay of treatment of refractory heart failure. There is a high incidence of dyselectrolytemia and suboptimal response due to diuretic resistance. Ultrafiltration by peritoneal route can be a safe and effective alternative. This study aims to study the ultrafiltration by peritoneal route in refractory heart failure patients with respect to change in functional status, renal parameters, left ventricular ejection fraction, number of days of hospitalization, and level of myocardial depressant factors. This was a prospective observational study conducted in Nephrology Department of tertiary care hospital. We studied patients with refractory heart failure who had persistent symptoms requiring frequent admissions despite optimal medical decongestion or had dyselectrolytemia with worsening renal parameters. The data were collected at baseline and then after 6 months of starting ultrafiltration. A total of 30 participants were studied. All the patients were in NYHA functional status Class IV before peritoneal ultrafiltration. There was a significant improvement in functional status and only 14 patients (46%) had Class III to Class IV status after application of ultrafiltration. (P < 0.001) There was a significant improvement in duration of hospital stay (75.8 ± 43.3 days to 7.8 ± 12.4, P > 0.001), serum creatinine (3.18 ± 0.98 to 2.16 ± 0.79 mg/dl, P < 0.001), and left ventricular ejection fraction [29.3 ± 7.4 (%) to 48.5 ± 11.8 (%), P < 0.0001] post ultrafiltration. There was also significant improvement in level of myocardial depressant factors (IL-1, IL-6, TNF alpha). Ultrafiltration by peritoneal route seems to be an effective alternative and should be offered to patients with chronic heart failure who are symptomatic despite maximal medical treatment.

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Section: Discussionmentioning

confidence: 99%

Ultrafiltration by peritoneal route in refractory chronic congestive cardiac failure

2018

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“…Fluid balance may possibly act as a biomarker of severity in critical illness [22]. A neutral fluid balance has also been shown to improve outcomes in acute lung injury.…”

Section: Other Aspects Of Adequacymentioning

confidence: 99%

Is Peritoneal Dialysis a Suitable Method of Renal Replacement Therapy in Acute Kidney Injury?

Rebić¹,

Herenda²

2016

Some Special Problems in Peritoneal Dialysis

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Research focus The role of peritoneal dialysis PD in the management of acute kidney injury "KI is not well defined, although it remains frequently used, especially in lowresource settings. " review was performed to ascertain its suitability as the first choice in "KI patient treatment and to compare PD with extracorporeal blood purification E"P , such as hemodialysis HD . Research methods used Design, setting, participants, and measurements of MEDLINE, CIN"HL, and Central Register of Controlled Trials were searched. The review selected eligible adult population studies on PD in the setting of "KI. Results/findings of the research This paper suggests that PD should be considered as a valuable method for "KI since it offers several advantages over HD, such as technical simplicity, no extracorporeal circuit, and no bleeding risk. It offers good cardiovascular tolerance and less cardiovascular instability, thus reducing kidney aggression by ischemia and hydroelectrolytic imbalance. Main conclusions and recommendations Finally, not only in developing countries but also in developed countries, PD is relatively simple and inexpensive and is more widely used. Various techniques of PD have been developed, and these have been adapted for use in "KI. There is currently no evidence to suggest significant differences in mortality between PD and HD in "KI. There is a need for further good-quality evidence in this important area.

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“…Peritoneal dialysis (PD) is useful for patients with end-stage renal disease with hemodynamic instability because of the continuous and slow ultrafiltration. 1,2 Furthermore, PD is an attractive therapeutic option in situations where hemodialysis (HD) may be undesirable due to a sudden onset of intradialytic hypotension and reductions in cerebral blood flow. 3 However, a meta-analysis on the risks of stroke in end-stage renal disease patients on PD compared to HD showed no differences in the risks of all types of stroke or ischemic stroke between PD and HD.…”

Section: Introductionmentioning

confidence: 99%

Clinical factors affecting cerebral oxygenation in patients undergoing peritoneal dialysis

Kitano

Ookawara

et al. 2021

Int J Artif Organs

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Background: Although cerebral regional oxygen saturation (rSO2) is significantly lower in hemodialysis (HD) patients than that in healthy controls, investigations on cerebral oxygenation in peritoneal dialysis (PD) patients are limited. We aimed to confirm the cerebral oxygenation status and identify the factors affecting cerebral rSO2 in PD patients. Methods: Thirty-six PD patients (21 men and 15 women; mean age, 62.8 ± 12.7 years) were recruited. In addition, 27 healthy volunteers (17 men and 10 women; mean age, 43.5 ± 18.8 years) were recruited as a control group. Cerebral rSO2 was monitored at the forehead using an INVOS 5100c oxygen saturation monitor. Results: Cerebral rSO2 was significantly lower in PD patients than that in healthy controls (57.0 ± 7.3% vs 68.9 ± 8.6%, p < 0.001); moreover, cerebral rSO2 was significantly correlated with natural logarithm (Ln)-PD duration ( r = −0.389, p = 0.019) and serum albumin concentration ( r = 0.370, p = 0.026) in a simple linear regression analysis. Multivariable linear regression analysis was performed using variables that showed a significant correlation and p < 0.20 (serum creatinine, serum sodium, Ln-C-reactive protein, and dosage of erythropoiesis-stimulating agent) with the cerebral rSO2. Cerebral rSO2 was independently associated with Ln-PD duration (standardized coefficient: −0.339) and serum albumin concentration (standardized coefficient: 0.316). Conclusions: Cerebral rSO2 was significantly affected by the PD duration and serum albumin concentration. Further prospective studies are needed to clarify whether preventing a decrease in serum albumin concentration leads to the maintenance of cerebral oxygenation in patients undergoing PD.

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Peritoneal dialysis in congestive heart failure

Cited by 4 publications

References 19 publications

Ultrafiltration by peritoneal route in refractory chronic congestive cardiac failure

Ultrafiltration by peritoneal route in refractory chronic congestive cardiac failure

Is Peritoneal Dialysis a Suitable Method of Renal Replacement Therapy in Acute Kidney Injury?

Clinical factors affecting cerebral oxygenation in patients undergoing peritoneal dialysis

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