Key result
Dialysis linked to ~71% fewer CV hospitalization days versus baseline in cardiorenal syndrome type 2.
Why the study?
Clinical outcomes and effects of dialysis treatment in patients with cardiorenal syndrome Type 2 and treatment-resistant congestive heart failure were not well characterized.
Does renal replacement therapy reduce hospitalizations in patients with treatment-resistant congestive heart failure and cardiorenal syndrome Type 2?
Observational (n=23)
Does renal replacement therapy reduce hospitalizations in patients with treatment-resistant congestive heart failure and cardiorenal syndrome Type 2?
Absolute Event Rate: 0.4% vs 1.4%
p-value: p=0.000
In patients with treatment-resistant heart failure and cardiorenal syndrome Type 2, starting dialysis significantly reduced cardiovascular hospitalizations and improved NYHA class, though technical complications were frequent.
May support dialysis consideration in refractory cardiorenal syndrome Type 2; hypothesis-generating pending randomized confirmation.
BACKGROUND/AIMS: Clinical outcome in cardiorenal syndrome (CRS) Type 2 and treatment with dialysis. METHODS: Prospective observational non-randomized study. RESULTS: Twenty-three patients were included, mean age 66±21 years. Twelve (52%) patients were treated with peritoneal dialysis (PD) and 11 (48%) with intermittent haemodialysis (IHD). Median survival time after start of dialysis was 16 months. Hospitalizations for cardiovascular causes were reduced (1.4±0.6 pre-dialysis versus 0.4±0.6 days/patient/month post-dialysis, P=0.000), without significant changes in hospitalization for all causes (1.8±1.6 versus 2.1±2.9 days/patient/month). New York Heart Association (NYHA) class (3.8±0.4 at start versus 2.4±0.7 after 4 months, P=0.000, versus 2.7±0.9 after 8 months, P=0.001) and quality of life tended to improve (63±21 at start, versus 41±20 after 4 months, versus 51±25 after 8 months; P=0.056). Left ventricular ejection fraction did not change. The number of technical complications associated with dialysis therapy was relatively high in this population. CONCLUSIONS: After starting dialysis for CRS, hospitalizations for cardiovascular causes were reduced, but not hospitalizations for all causes. Functional NYHA class improved and quality of life tended to improve, without evidence for a change in cardiac function. In this small study, no differences between IHD and PD were observed.
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Cnossen et al. (2012) conducted an observational in Cardiorenal syndrome (CRS) Type 2 / treatment-resistant congestive heart failure (n=23). Dialysis (peritoneal dialysis or intermittent haemodialysis) vs. Pre-dialysis baseline was evaluated on Hospitalizations for cardiovascular causes (days/patient/month) (p=0.000). Dialysis in patients with cardiorenal syndrome Type 2 significantly reduced hospitalizations for cardiovascular causes from 1.4 to 0.4 days/patient/month (P=0.000).
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