Why the study?
Does peritoneal dialysis improve hospitalisation rate, functional status, and quality of life in patients with chronic congestive heart failure and cardiorenal syndrome type 2?
Does peritoneal dialysis improve hospitalisation rate, functional status, and quality of life in patients with chronic congestive heart failure and cardiorenal syndrome type 2?
Peritoneal dialysis may be an effective strategy for managing fluid overload in patients with heart failure and cardiorenal syndrome type 2 who have developed diuretic resistance.
Hypothesis-generating for peritoneal dialysis in cardiorenal syndrome type 2; prospective randomized trials needed before clinical adoption.
Maladaptive responses between a failing heart and the kidneys ultimately lead to permanent chronic kidney disease, referred to as cardiorenal syndrome type 2. In this narrative review, we discuss the pathophysiological pathways in the progression of cardiorenal failure and review the current evidence on peritoneal dialysis as a treatment strategy in cardiorenal syndrome type 2. A patient with heart failure can present with clinical symptoms related to venous congestion even in the absence of end-stage renal disease. Diuretics remain the cornerstone for the treatment of fluid overload related to heart failure. However, with chronic use, diuretic resistance can supervene. When medical therapy is no longer able to relieve congestive symptoms, ultrafiltration might be needed. Patients with heart failure tolerate well the gentle rate of fluid removal through peritoneal dialysis. Recent publications suggest a positive impact of starting peritoneal dialysis in patients with cardiorenal syndrome type 2 on the hospitalisation rate, functional status and quality of life.
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François et al. (2015) studied this question.
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