PMID- 33250003
OWN - NLM
STAT- MEDLINE
DCOM- 20220502
LR  - 20220502
IS  - 1718-4304 (Electronic)
IS  - 0896-8608 (Linking)
VI  - 42
IP  - 1
DP  - 2022 Jan
TI  - Favorable effects of peritoneal dialysis in patients with refractory heart 
      failure and overhydration.
PG  - 48-56
LID - 10.1177/0896860820970097 [doi]
AB  - BACKGROUND: Patients with refractory to optimal pharmacological treatment heart 
      failure (HF) require frequent hospitalization. Peritoneal dialysis (PD) has been 
      part of the management of such patients mainly for promoting ultrafiltration and 
      management of overhydration independently of kidney function. The aim of this 
      study was to evaluate the efficacy of PD, especially the use of icodextrin 
      solutions and intermittent PD, in the hospitalization rate and cardiac functional 
      status of patients with HF. METHODS: We conducted a retrospective study involving 
      patients with New York Heart Association (NYHA) class IV HF and preserved renal 
      function (estimated glomerular filtration rate (eGFR) > 25 ml/min), who were 
      refractory to conservative treatment. Clinical data on weight loss, 
      hospitalization rate before and after PD initiation, cardiac functional status, 
      and technique complications during a 6-month observational period were analyzed. 
      RESULTS: PD treatment was performed in 32 patients with a mean age of 63.8 +/- 11.9 
      years and a follow-up of 20.78 +/- 14.24 months. Hospitalizations were 
      significantly reduced from 20.7 +/- 13.7 to 7.7 +/- 8.9 days/patients at 6 months. 
      All patients showed improvement in NYHA class as well as in left ventricular 
      ejection fraction. Overall, eGFR showed a significant decrease but only six 
      patients reached end-stage renal disease. Complications included 18 cases of 
      peritonitis. PD was well tolerated and no patient dropped out of the method. 
      Survival rate reached 72% at 12 months but mortality rate was high with 23 
      patients dying at 16.65 +/- 12.3 months after the initiation of treatment. Patients 
      survival was not influenced by the type of PD modality or weight reduction 
      achieved. CONCLUSIONS: PD showed to be a viable option for the treatment of 
      patients with refractory HF leading to a better cardiac functional status and 
      diminishing the number of hospital admissions.
FAU - Papasotiriou, Marios
AU  - Papasotiriou M
AUID- ORCID: 0000-0001-9375-989X
AD  - Department of Nephrology and Kidney Transplantation, University Hospital of 
      Patras, Greece.
FAU - Liakopoulos, Vassilios
AU  - Liakopoulos V
AD  - 1st Department of Internal Medicine, Division of Nephrology and Hypertension, 
      Aristotle University of Thessaloniki, Greece.
FAU - Kehagias, Ioannis
AU  - Kehagias I
AD  - Department of Surgery, University Hospital of Patras, Greece.
FAU - Vareta, Georgia
AU  - Vareta G
AD  - 1st Department of Internal Medicine, Division of Nephrology and Hypertension, 
      Aristotle University of Thessaloniki, Greece.
FAU - Ntrinias, Theodoros
AU  - Ntrinias T
AD  - Department of Nephrology and Kidney Transplantation, University Hospital of 
      Patras, Greece.
FAU - Papachristou, Evangelos
AU  - Papachristou E
AD  - Department of Nephrology and Kidney Transplantation, University Hospital of 
      Patras, Greece.
FAU - Goumenos, Dimitrios S
AU  - Goumenos DS
AD  - Department of Nephrology and Kidney Transplantation, University Hospital of 
      Patras, Greece.
LA  - eng
PT  - Journal Article
DEP - 20201128
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  - Female
MH  - *Heart Failure/complications/therapy
MH  - Humans
MH  - *Kidney Failure, Chronic/complications/diagnosis/therapy
MH  - Male
MH  - Middle Aged
MH  - *Peritoneal Dialysis/adverse effects/methods
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - *Water-Electrolyte Imbalance/etiology
OTO - NOTNLM
OT  - Heart failure
OT  - intermittent peritoneal dialysis
OT  - peritoneal ultrafiltration
OT  - ultrafiltration
EDAT- 2020/12/01 06:00
MHDA- 2022/05/03 06:00
CRDT- 2020/11/30 05:25
PHST- 2020/12/01 06:00 [pubmed]
PHST- 2022/05/03 06:00 [medline]
PHST- 2020/11/30 05:25 [entrez]
AID - 10.1177/0896860820970097 [doi]
PST - ppublish
SO  - Perit Dial Int. 2022 Jan;42(1):48-56. doi: 10.1177/0896860820970097. Epub 2020 
      Nov 28.