Effectiveness and Safety of Peritoneal Dialysis Treatment in Patients with Refractory Congestive Heart Failure due to Chronic Cardiorenal Syndrome

Shao, Qiuyuan; Xia, Yangyang; Zhao, Min; Liu, Jing; Zhang, Qingyan; Jin, Bo; Xie, Jun; Xu, Biao; Gong, Rujun; Jiang, Chunming

doi:10.1155/2018/6529283

Cited by 13 publications

(16 citation statements)

References 33 publications

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“…There was a significant decrease in patients’ body weight in our study. This result was consistent with previous studies [22, 23]. We found a significant reduction in the degree of ascites, pretibial edema, and pleural effusion.…”

Section: Discussionsupporting

confidence: 94%

“…In a meta-analysis [13] ( n = 282) of six studies, in which ESRD patients were not included, no significant change in eGFR after PD treatment was reported. In the study by Shao et al [22], there was no significant change in eGFR of patients with type 2 CRS after PD, but the decrease in eGFR in patients with other types of CRS was significant. The reason for this increase of eGFR in the first three months may be related to decreased intra-abdominal pressure and improvement of renal perfusion.…”

Section: Discussionmentioning

confidence: 97%

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Usefulness of Peritoneal Ultrafiltration in Patients with Diuretic Resistant Heart Failure without End-Stage Renal Disease

et al. 2020

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This study aimed to explore the role of peritoneal ultrafiltration (UF) in cardiorenal syndrome (CRS) patients for fluid and metabolic control. Background: Peritoneal UF is safely and efficiently used for the management of CRS. It has been shown to provide efficient UF in hypervolemic patients. Methods: Thirty (20 males and 10 females) CRS patients were treated by peritoneal dialysis (PD) and UF. The baseline data of the patients (demographics, causes of heart failure, the presence of pacemaker or implantable cardioverter-defibrillator, the need for extracorporeal UF or paracentesis or thoracentesis, comorbidity, drugs, left ventricular ejection fraction [LVEF] and pulmonary artery systolic pressure [PAPs], pericardial effusion, physical examination, body weight, NYHA class, dialysis regime, urine output, N-terminal pro-B-type natriuretic peptide [NT-proBNP] level, hemoglobin, estimated glomerular filtration rate [eGFR], and other routine biochemical determinations) were recorded at the onset, every 6 months, and then annually. Echocardiograms were performed at baseline and after 6 and 12 months. The time points of complications associated with PD, the need for hemodialysis, the day of death, and causes of death were documented. Results: Mean age was 69 ± 8 years (range 49-84 years). The average PD duration was 18.25 ± 14.87 months. According to the CKD-EPI, initial mean GFR was 34.34 ± 11.9 mL/min/1.73 m 2 (range 16.57-59.0), and this increased to 45.48 ± 26.04, 45.10 ± 28.58, and 41.10 ± 25.68 mL/min/1.73 m 2 in the third, sixth, and twelfth months, respectively. There was a significant increase in the first 3 months and a significant decrease between the third and twelfth months (respectively, p = 0.018 and p = 0.043). There was no difference in eGFR levels between baseline and the end of the first year (p = 0.217). In the first 3 months, there was a significant decline in urea levels to 79.38 ± 36.65

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 97%

Usefulness of Peritoneal Ultrafiltration in Patients with Diuretic Resistant Heart Failure without End-Stage Renal Disease

et al. 2020

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“…Diálise peritoneal, outra modalidade de terapia renal substitutiva, está relacionada com uma estabilidade hemodinâmica em pacientes com insuficiência cardíaca. Dentre seus benefícios destacam-se um alívio nas pressões intraabdominais e na pressão venosa renal, além de poder drenar ascites, melhorar a taxa de filtração glomerular, aumentar a diurese e normalizar a creatinina sérica (Shao et al, 2018;Grossekettler et al, 2019).…”

Section: Discussionunclassified

Fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca

Gonçalves

Sousa

Farias

2021

RSD

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Objetivo: analisar, a partir de uma revisão sistemática da literatura, quais são os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca. Métodos: efetuou-se uma revisão sistemática da literatura a partir da questão de pesquisa “Quais os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca?”. Para a seleção dos artigos que compõem este estudo, realizou-se uma busca nas seguintes bases de dados: Medical Publisher (PUBMED), Biblioteca Virtual em Saúde (BVS), Science Direct (SD) e Semantic Scholar utilizando-se como critérios de elegibilidade apenas estudos observacionais ou ensaios clínicos randomizados, que contemplassem a questão de pesquisa, que fossem relevantes e atuais para abordar o tema. A amostra final é composta por 25 publicações. Resultados: os principais fatores preditivos para o desenvolvimento da síndrome cardiorrenal se associam com os fatores de risco cardiovasculares e às manifestações geradas a partir do comprometimento renal. Conclusão: a junção de comorbidades do paciente, com fatores de risco para desenvolvimento de doença cardiovascular, de injúria renal aguda associado com marcadores laboratoriais de injúria miocárdica e de lesão renal podem atuar como fatores preditivos confiáveis para o desenvolvimento da síndrome cardiorrenal.

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“…14-17 In addition, recent reviews have demonstrated that PD is a safe and feasible treatment for the management of symptoms in patients with refractory HF. 18,19…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Retrospective Study on the Initiation of Peritoneal Dialysis in Patients With Cardiorenal Syndrome and Subsequent Hospitalizations

Auguste

Agarwal

Ibrahim

et al. 2020

Can J Kidney Health Dis

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Background: Inotropic dependence and diuretic resistance in patients with cardiorenal syndrome (CRS) lead to frequent hospitalizations and are associated with high mortality. Starting peritoneal dialysis (PD) acutely (within 2 weeks of a heart failure hospitalization) offers effective volume removal without hemodynamic compromise in this population. There is little data on this approach in the North American literature. Objective: To determine whether volume-overloaded patients with CRS on maximal doses of diuretic therapy had reduced hospitalization for heart failure following PD initiation. Design: Retrospective cohort study. Setting: Academic hospital network (University Health Network, Toronto, Ontario). Patients: Patients with CRS receiving a bedside catheter and starting PD within 2 weeks of insertion at the University Health Network from January 1, 2013, to December 31, 2018. Methods and measurements: Data for heart failure–related hospitalizations and length of stay 6 months before and after PD initiation were collected. Patients who died, switched to hemodialysis, or were transferred to another facility within 6 months of starting PD were excluded from the analysis. Results: We identified 31 patients with CRS who had a bedside PD catheter inserted. The average age of patients was 66.0 ± 13.0 years. There were 7 (22.6%) deaths and 4 (12.9%) transfers to other programs or hemodialysis within 6 months of catheter insertion. After exclusion, we analyzed hospitalization and length of stay data for 20 patients. The hospitalization rate 6 months before PD initiation was 6.9 admissions per 1000 patient-days. This decreased to 2.5 admissions per 1000 patient-days after PD initiation. In addition, there was also a significant reduction in the average length of stay per hospitalization (24.1-3.9 days; P = .001). Limitations: Our study did not assess the severity of heart failure symptoms using a standardized functional classification system. We did not assess quality of life and illness intrusiveness scores before and after starting dialysis, nor did we capture non–heart-failure-related hospitalizations or external admissions at other hospital sites. We limited eligibility to clinically stable patients with no prior major abdominal surgical history in a single Canadian PD program using bedside ultrasound approach for catheter insertions by experienced nephrologists and included a small number of patients. Conclusions: Volume-overloaded patients with CRS receiving maximal diuretic therapy have lower hospitalization rates and shorter stays after initiation of PD. The development of a bedside PD catheter insertion program and close collaboration between nephrology and cardiology services may facilitate acute start dialysis in this population.

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Effectiveness and Safety of Peritoneal Dialysis Treatment in Patients with Refractory Congestive Heart Failure due to Chronic Cardiorenal Syndrome

Cited by 13 publications

References 33 publications

Usefulness of Peritoneal Ultrafiltration in Patients with Diuretic Resistant Heart Failure without End-Stage Renal Disease

Usefulness of Peritoneal Ultrafiltration in Patients with Diuretic Resistant Heart Failure without End-Stage Renal Disease

Fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca

A Single-Center Retrospective Study on the Initiation of Peritoneal Dialysis in Patients With Cardiorenal Syndrome and Subsequent Hospitalizations

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