Key result
Peritoneal dialysis linked to improved NYHA class in ~80% of refractory CHF patients.
Why the study?
Ultrafiltration techniques like peritoneal dialysis are valuable alternatives to pharmacological therapy in refractory congestive heart failure, but clinical experience is limited.
Does peritoneal dialysis improve clinical outcomes and reduce hospitalizations in patients with refractory congestive heart failure?
Observational (n=5)
No
Does peritoneal dialysis improve clinical outcomes and reduce hospitalizations in patients with refractory congestive heart failure?
Peritoneal dialysis may serve as a viable adjunctive therapy to improve functional class and reduce hospitalizations in patients with severe, refractory congestive heart failure.
Supports peritoneal dialysis consideration in refractory HF; hypothesis-generating from Level 4 data and requires RCTs before practice change.
INTRODUCTION: Ultrafiltration (UF) technique is a valuable alternative to pharmacological therapy in the treatment of patients with refractory congestive heart failure (HF). The aim of this study was to describe a single-center experience in the treatment of refractory HF patients with peritoneal dialysis (PD). METHODS: Retrospective study of 5 patients included in a single PD Unit, showing symptoms and signs of severe refractory congestive HF to optimal pharmacological therapy (NYHA class IV). Clinical and laboratory parameters, survival, hospitalization, and peritonitis rates were recorded. RESULTS: Patients were followed for 9.36 (± 6.36) months; population mean age was 62 (± 16) years and Charlson's comorbidity index was 7.2 (± 2.1). After PD therapy, functional class of NYHA significantly improved (class IV to class II in 4 patients). Doppler-echocardiography improved in terms of ejection fraction (EF) or systolic pressure of the pulmonary artery (SPPA) in 3 patients. No patient was readmitted due to HF. Hospitalization days substantially decreased in 4 patients. One patient presented with peritonitis episodes. Three patients died but the mean survival was higher than expected according to their comorbidity index. CONCLUSION: PD, applied to refractory HF in addition to optimal pharmacological therapy, improves quality of life and functional class and reduces hospitalization days due to HF.
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Querido et al. (2016) conducted an observational in refractory congestive heart failure (n=5). Peritoneal dialysis was evaluated on NYHA functional class improvement (class IV to class II). Peritoneal dialysis improved NYHA functional class from IV to II in 80% (4 of 5) of patients with refractory congestive heart failure and reduced hospitalization days.
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