Clinical significance of renal hemodynamics in severe congestive heart failure: responsiveness to ultrafiltration therapies.
Isolated ultrafiltration, hemodialysis & peritoneal dialysis (Tx) were recently used in the treatment of intractable heart failure (HF). We examined the relation between the response of HF to Tx and the residual kidney functions. Tx was carried out in 17 patients (Pts) with HF who did not respond to aggressive medical treatment. Ten Pts (R) responded to Tx and 7 Pts (N) did not. Serum urea nitrogen (UN), creatinine (Cr), uric acid (UA), sodium (Na), potassium (K), and chloride (Cl) concentrations on admission and before Tx were not different between R and N. Urine UN, Cr, Na, K, and Cl on admission and before Tx were also not significantly different. Fractional sodium excretions (FENa), renal failure indices (RFI), and urine/plasma Cr ratios (U/P Cr) on admission were 2.0 +/- 1.6, 2.7 +/- 2.2, and 30.5 +/- 20.0 in R and 5.9 +/- 4.2, 8.2 +/- 6.0 and 11.5 +/- 3.8 in N. They were significantly different (p less than 0.05). However, these did not differ before and after Tx. These data show that FENa, RFI and U/P Cr might be useful indices in predicting the responsiveness of intractable HF to Tx.
Akiba
T
T
Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
Taniguchi
K
K
Marumo
F
F
Matsuda
O
O
D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012079:Renal Circulation; D006435:Renal Dialysis; D014462:Ultrafiltration