Successful Peritoneal Dialysis for the Treatment of Inotrope-Dependent End-Stage Heart Failure

Sugiura, Emiyo; Dohi, Kaoru; Tanimura, Muneyoshi; Kumagai, Naoto; Ishikawa, Eiji; M, Ito

doi:10.1536/ihj.18-550

Cited by 4 publications

(3 citation statements)

References 22 publications

(39 reference statements)

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“…The improvement in quality of life can be dramatic. PD therapy can improve the functional status of patients with severe diuretic-resistant heart failure whose vital functions can only be maintained by vasopressors [ 43 ]. Several reports have reported decreased hospitalization with PD treatment in such patients [ 44 , 45 ].…”

Section: Peritoneal Dialysis In Diuretic-resistant Heart Failurementioning

confidence: 99%

The Importance of the Nephrologist in the Treatment of the Diuretic-Resistant Heart Failure

Pethő

Tapolyai

Browne

et al. 2023

Life

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Heart failure is not only a global problem but also significantly limits the life prospects of these patients. The epidemiology and presentation of heart failure are intensively researched topics in cardiology. The risk factors leading to heart failure are well known; however, the real challenge is to provide effective treatments. A vicious cycle develops in heart failure of all etiologies, sooner or later compromising both cardiac and kidney functions simultaneously. This can explain the repeated hospital admissions due to decompensation and the significantly reduced quality of life. Moreover, diuretic-refractory heart failure represents a distinct challenge due to repeated hospital admissions and increased mortality. In our narrative review, we wanted to draw attention to nephrology treatment options for severe diuretic-resistant heart failure. The incremental value of peritoneal dialysis in severe heart failure and the feasibility of percutaneous peritoneal dialysis catheter insertion have been well known for many years. In contrast, the science and narrative of acute peritoneal dialysis in diuretic-resistant heart failure remains underrepresented. We believe that nephrologists are uniquely positioned to help these patients by providing acute peritoneal dialysis to reduce hospitalization dependency and increase their quality of life.

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Section: Peritoneal Dialysis In Diuretic-resistant Heart Failurementioning

confidence: 99%

The Importance of the Nephrologist in the Treatment of the Diuretic-Resistant Heart Failure

Pethő

Tapolyai

Browne

et al. 2023

Life

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“…The first reported case of treating a congestive HF patient with PD dates back to 1949 [37], but its use has gained progressive interest over the last two decades. Case reports, case series, and small cohort studies have reported favorable outcomes in different patient settings, from severely reduced to preserved ejection fraction and in various types of cardiomyopathies [10,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. PD constitutes a home-based therapeutic modality that offers the possibility of continuous and gentle removal of excess water and solutes with minimal hemodynamic impact, allows easing the renal venous and intraabdominal pressure while draining ascites and interstitial edema, and has a high capacity of customization to the patient's clinical requirements and daily life.…”

Section: The Role Of Peritoneal Dialysismentioning

confidence: 99%

Peritoneal dialysis in heart failure: focus on kidney and ventricular dysfunction

Morales¹,

Barbosa²,

Farré³

2021

Reviews in Cardiovascular Medicine

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Heart failure is a significant health problem worldwide. Despite all the new therapies available nowadays, many patients will reach advanced stages of the disease. Diuretic resistance, kidney dysfunction, and refractory congestion, all highly prevalent in advanced heart failure, frequently complicate the situation, making it more challenging to manage. Ultrafiltration through hemodialysis or peritoneal dialysis can be alternative options to treat fluid overload. Peritoneal dialysis has gained increased interest in the last decades due to several benefits such as functional class improvement, reduction in hospital admissions, improvement in quality of life, and even a reduction in mortality shown by numerous cohort studies. However, the majority of the studies were observational and with a limited number of patients. In addition, the optimal timing for the initiation of this type of therapy and the subgroup of patients who would benefit the most from it is unknown. Hence, randomized controlled trials in this subject are urgently needed. We aim to review the contemporary evidence of peritoneal dialysis in patients with heart failure and diuretic resistance across the spectrum of ventricular dysfunction and degree of renal dysfunction.

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“…End-stage renal disease (ESRD) has been demonstrated to be accompanied by various cardiovascular complications, which usually have poor outcomes (Kim and Parekh, 2015;Ramesh et al, 2016;Samanta et al, 2019). It has been reported that cardiovascular events, including heart failure, are the leading causes of death in ESRD patients (Kooman and van der Sande, 2019;Sugiura et al, 2019;Yogasundaram et al, 2019). The progressively deteriorating structure and function of the heart may be the consequence of renal failure (Cutshall et al, 2018;Unlu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Independent Risk Factors of Significant Tricuspid Regurgitation Jets in Maintenance Hemodialysis Patients With ESRD

et al. 2020

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Background and AimTricuspid regurgitation (TR) is a frequent complication in various cardiovascular diseases. However, few studies have reported the prevalence of TR especially the moderate to severe or significant TR (ms-TR) maintenance dialysis patients. Thus, we aimed to identify the prevalence of ms-TR and its associated factors.MethodsA total of 491 maintenance dialysis patients underwent echocardiographic examinations, while a subgroup (n = 283) also received routine blood tests, renal function examinations, and electrolyte analysis. We first compared the differences in abovementioned parameters among groups with various TR areas (TRAs). Finally, univariate and adjusted regression were also used to identify factors that were independently associated with ms-TR.ResultsThe incidence of TR jets was 62.6%, which included a mildly increased TRA (47.8%), moderately increased TRA (10.4%), and severely increased TRA (3.5%). Most of the cardiac structures and functional parameters, such as the end-diastolic internal diameters of the left atrium (LA), left ventricle (LVDD), right atrium (RA), right ventricle (RV), left ventricular ejection fraction (LVEF), and fractional shortening (FS), were significantly associated with ms-TR. Among serum ions, only total CO2 (TCO2; r = −0.141, p = 0.047) was negatively correlated with TRA. After adjusted, only Na+ [odds ratio (OR): 0.871 0.888, p = 0.048], RA (OR: 1.370, p < 0.001), and FS (OR: 0.887, p < 0.001) were independently associated with ms-TR.ConclusionTricuspid regurgitation occurs in maintenance hemodialysis patients with ESRD. Na+ FS and RA were independently associated with ms-TR, and these parameters may be potential risk factors/predictors for ms-TR.

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Successful Peritoneal Dialysis for the Treatment of Inotrope-Dependent End-Stage Heart Failure

Cited by 4 publications

References 22 publications

The Importance of the Nephrologist in the Treatment of the Diuretic-Resistant Heart Failure

The Importance of the Nephrologist in the Treatment of the Diuretic-Resistant Heart Failure

Peritoneal dialysis in heart failure: focus on kidney and ventricular dysfunction

The Prevalence and Independent Risk Factors of Significant Tricuspid Regurgitation Jets in Maintenance Hemodialysis Patients With ESRD

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