Peritoneal dialysis as a therapeutic approach in congestive heart failure resistant to pharmacological treatment

Próchnicka, Agnieszka; Olszowska, Anna; Baczyński, Daniel; Zelichowski, Grzegorz; Wańkowicz, Z

doi:10.20452/pamw.851

Cited by 5 publications

(10 citation statements)

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“…Case series in which PD was applied are classified into two clinical groups by kidney function (Table 1): patients with end-stage renal disease (39,40,43,46,47,51,53) and nonuremic pre-dialysis patients (37)(38)(39)(40)(42)(43)(44)(45)(46)(48)(49)(50)(51)(52)(53). The former group includes patients with CRS type IV, and case reports for those patients indicate that PD induction can benefit end-stage renal disease patients complicated with severe CHF.…”

Section: Clinical Outcomes Of Pd For Crs Types II and Iv With Chfmentioning

confidence: 99%

Nonuremic Indication for Peritoneal Dialysis for Refractory Heart Failure in Cardiorenal Syndrome Type II: Review and Perspective

Nakayama

2013

Perit Dial Int

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Cardiorenal syndrome (CRS) type II is a serious condition in which chronic cardiac abnormalities cause worsening kidney function, leading to permanent chronic kidney damage. Management of CRS type II coupled with diuretic-resistant congestive heart failure (CHF) has been an issue of dispute. However, since the early 1990s, reports indicating the clinical usefulness of peritoneal dialysis (PD) as maintenance therapy for intractable CHF in this population have been accumulating. The present manuscript reviews the mechanisms by which kidney dysfunction develops within CHF, and then examines recent experiences of PD as chronic supportive therapy for intractable CRS type II, reviews the contributing mechanisms, and discusses the rationale for using PD as a new therapeutic approach in the nonuremic setting of CHF.

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Section: Clinical Outcomes Of Pd For Crs Types II and Iv With Chfmentioning

confidence: 99%

Nonuremic Indication for Peritoneal Dialysis for Refractory Heart Failure in Cardiorenal Syndrome Type II: Review and Perspective

Nakayama

2013

Perit Dial Int

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“…Our Center was a first polish institution to introduce peritoneal ultrafiltration in place of extracorporeal ultrafiltration as a treatment method of patients with CHF [35,55,56]. …”

Section: Dialysotherapy After 50 Years – Further Development or Stagnmentioning

confidence: 99%

The role of technological progress vs. accidental discoveries and clinical experience

Wańkowicz

2013

Med Sci Monit

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The 50th anniversary of dialysotherapy celebrated by nephrologists around the world in 2012 provided an opportunity for discussion on the role of clinical experience in relation to technological progress in the evolution of dialysis, especially of recently observed inadequate decrease in mortality/morbidity rates of patients on chronic dialysis. My report, based on almost 50 years of career in nephrology, refers the evolution of dialysis, from catharsis to modern dialysotherapy with special attention devoted to nowadays gravely underestimated role of clinical experience and personalized professional care for patients.

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“…On the basis of our results we proposed icodextrin solution for long dwells in peritoneal ultrafiltration or peritoneal dialysis in patients with CHF resistant to pharmacological treatment. Additional rationale for this therapeutic option was provided by the case report of a 37-year-old patient with terminal CHF who had been considered ineligible for heart transplantation and previously insufficiently treated with hemodialysis [51]. …”

Section: Long Dwell Pd With Icodextrin Solution – How Does It Work?mentioning

confidence: 99%

“…From the 1960s through the 1980s intermittent PD was used as a salvage therapy in severe heart failure resistant to diuretics [18,49]. Since then, more than 300 patients with CHF (NYHA class III to IV) with or without chronic kidney disease have been treated with different forms of peritoneal dialysis, with pUF employed in not more than 100 cases [43,51]. Variations in pUF range from 1 daily long-term exchange with hypertonic glucose or icodextrin solution, through intermittent or incremental PD procedure in patients with GFR above 15.0 mL/min/1.73 m 2 , to regular CAPD or APD program in patients with CHF and GFR below 15.0 mL/min/1.73 m 2 [43–49,60].…”

Section: Peritoneal Ultrafiltration In Chf – Clinical Experiencementioning

confidence: 99%

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Extracorporeal versus peritoneal ultrafiltration in diuretic-resistant congestive heart failure – a review

et al. 2011

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SummaryDiuretic-resistant congestive heart failure in the form of type 2 cardiorenal syndrome is a problem of growing significance in everyday clinical practice because of high morbidity and mortality. There has been scant progress in the treatment of overhydration, the main cause of symptoms in this group of patients. The aim of our review is to present recent advances in the ultrafiltration therapy of congestive heart failure, with special attention to the new dedicated device for extracorporeal isolated ultrafiltration, as well as modifications of peritoneal dialysis in the form of peritoneal ultrafiltration with icodextrin solution and incremental peritoneal dialysis. Technical and clinical features, costs and potential risks of available devices for isolated ultrafiltration are presented. This method should be reserved for patients with true diuretic resistance as part of a more complex strategy aiming at the adequate control of fluid retention. Peritoneal ultrafiltration is presented as a viable alternative to extracorporeal ultrafiltration because of medical and psychosocial benefits of home-based therapy, lower costs and more effective daily ultrafiltration. In conclusion, large, properly randomized and controlled clinical trials with long-term follow-up will be essential in assessing the logistics and cost-effectiveness of both methods. Most importantly, however, they should be able to evaluate the impact of both methods on preservation of renal function and delaying the progression of heart failure by interrupting the vicious circle of cardiorenal syndrome. Our review is supplemented with the case report of the use of peritoneal ultrafiltration with a single 12-hour nighttime icodextrin exchange as a life-saving procedure in a patient with congestive heart failure resistant to pharmacological treatment.

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Peritoneal dialysis as a therapeutic approach in congestive heart failure resistant to pharmacological treatment

Cited by 5 publications

References 0 publications

Nonuremic Indication for Peritoneal Dialysis for Refractory Heart Failure in Cardiorenal Syndrome Type II: Review and Perspective

Nonuremic Indication for Peritoneal Dialysis for Refractory Heart Failure in Cardiorenal Syndrome Type II: Review and Perspective

The role of technological progress vs. accidental discoveries and clinical experience

Extracorporeal versus peritoneal ultrafiltration in diuretic-resistant congestive heart failure – a review

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