PMID- 31501293
OWN - NLM
STAT- MEDLINE
DCOM- 20200806
LR  - 20200806
IS  - 1718-4304 (Electronic)
IS  - 0896-8608 (Linking)
VI  - 39
IP  - 5
DP  - 2019 Sep-Oct
TI  - Peritoneal Ultrafiltration for Heart Failure: Lessons from a Randomized 
      Controlled Trial.
PG  - 486-489
LID - 10.3747/pdi.2018.00272 [doi]
AB  - Peritoneal ultrafiltration (PuF) has been employed for severe heart failure (HF), 
      but evidence for its benefit is lacking. The Peritoneal Dialysis for Heart 
      Failure (PDHF) study was a multicenter prospective randomized controlled trial 
      which aimed to investigate this issue. The trial stopped early due to inadequate 
      recruitment. We describe methods, trial activity, and lessons learned.The trial 
      aimed to recruit 130 participants with severe diuretic-resistant HF (New York 
      Heart Association [NYHA] 3/4) and chronic kidney disease (CKD) stage 3/4 on 
      optimal medical treatment for >/= 4 weeks from 6 UK centers. Participants were 
      randomized to either continuation of conventional HF treatment or to additionally 
      receiving PuF (1 overnight exchange using Icodextrin dialysate). Primary outcome 
      was change in 6-minute walk test (6MWT) between baseline and 28 weeks (end of 
      trial). Secondary outcomes were changes in patient reported quality of life as 
      assessed by the Kansas City Cardiomyopathy Questionnaire, short form 36 (SF 36) 
      health survey results, hospitalization, and mortality.Over a 2-year period, 290 
      patients were screened from which only 20 met inclusion criteria and 10 were 
      recruited. Reasons for ineligibility were fluctuating estimated glomerular 
      filtration rate (eGFR), suboptimal HF treatment, frailty, and patients being too 
      unwell for randomization. Barriers to recruitment included patient frailty, with 
      some participants considered only when they were at end of life, unwillingness to 
      engage in an invasive therapy, and suboptimal coordination between cardiology and 
      renal services. This is a challenging patient group in which to perform research, 
      and lessons learned from the peritoneal dialysis (PD)-HF trial will be helpful in 
      the planning of future studies in this area.
CI  - Copyright (c) 2019 International Society for Peritoneal Dialysis.
FAU - Dukka, Hari
AU  - Dukka H
AD  - University Hospitals of Derby and Burton, Derby, UK hari.dukka@nhs.net.
FAU - Kalra, Philip A
AU  - Kalra PA
AD  - University of Manchester, Manchester, UK.
FAU - Wilkie, Martin
AU  - Wilkie M
AD  - Sheffield Kidney Institute, Sheffield, UK.
FAU - Bhandari, Sunil
AU  - Bhandari S
AD  - Hull and East Yorkshire NHS Trust, Hull, UK.
FAU - Davies, Simon J
AU  - Davies SJ
AD  - Faculty of Medicine and Health Sciences, Keele University, UK.
FAU - Barratt, Jonathan
AU  - Barratt J
AD  - University of Leicester and NIHR Biomedical Research Centre, Leicester, UK.
FAU - Squire, Iain
AU  - Squire I
AD  - University of Leicester and NIHR Biomedical Research Centre, Leicester, UK.
FAU - Odudu, Aghogho
AU  - Odudu A
AD  - University of Manchester, Manchester, UK.
FAU - Selby, Nicholas M
AU  - Selby NM
AD  - University Hospitals of Derby and Burton, Derby, UK.
AD  - Centre for Kidney Research and Innovation, Division of Medical Sciences and 
      Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
FAU - McIntyre, Christopher
AU  - McIntyre C
AD  - The University of Western Ontario, London, Canada.
FAU - Robertson, Fiona
AU  - Robertson F
AD  - Centre for Kidney Research and Innovation, Division of Medical Sciences and 
      Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
FAU - Taal, Maarten W
AU  - Taal MW
AD  - University Hospitals of Derby and Burton, Derby, UK.
AD  - Centre for Kidney Research and Innovation, Division of Medical Sciences and 
      Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
SB  - IM
MH  - Aged
MH  - Heart Failure/complications/*therapy
MH  - *Hemodiafiltration
MH  - Humans
MH  - Middle Aged
MH  - Peritoneal Dialysis/*methods
MH  - Prospective Studies
MH  - *Randomized Controlled Trials as Topic
MH  - Renal Insufficiency, Chronic/complications/therapy
OTO - NOTNLM
OT  - Peritoneal dialysis for heart failure
OT  - recruitment difficulties
OT  - symptom control and quality of life
EDAT- 2019/09/11 06:00
MHDA- 2020/08/07 06:00
CRDT- 2019/09/11 06:00
PHST- 2019/09/11 06:00 [entrez]
PHST- 2019/09/11 06:00 [pubmed]
PHST- 2020/08/07 06:00 [medline]
AID - 39/5/486 [pii]
AID - 10.3747/pdi.2018.00272 [doi]
PST - ppublish
SO  - Perit Dial Int. 2019 Sep-Oct;39(5):486-489. doi: 10.3747/pdi.2018.00272.