title: Chronic intermittent haemofiltration and haemodialysis in end stage chronic heart failure with oedema refractory to high dose frusemide.
abstract: OBJECTIVE
  To assess the benefits and problems of chronic intermittent treatment with haemofiltration or haemodialysis or both in patients with severe chronic heart failure (New York Heart Association class III or IV) and oedema refractory to pharmacological treatment.
  
  
  METHODS
  A retrospective case-cohort study. A general hospital in The Netherlands.
  
  
  METHODS
  The results of chronic intermittent treatment with haemofiltration (n = 10) or haemodialysis (n = 2) were analysed in patients with severe chronic heart failure, predominantly due to coronary heart disease, and oedema refractory to a pharmacological regimen including high dose frusemide.
  
  
  METHODS
  Patients had an average of 25 (SD 38) treatments.
  
  
  RESULTS
  There was improvement of NYHA class IV to III in seven patients. However, this was not reflected in a decrease in hospital admission: only two patients could be managed as outpatients. The median survival after start of the treatment was 24 days (varying from 0 to 393 days). In four patients the treatment was discontinued after discussion with the patient and family.
  
  
  CONCLUSIONS
  The use of chronic intermittent haemofiltration and haemodialysis is of limited value in end stage chronic heart failure with oedema, refractory to maximal conventional treatment.
authors.affiliation: Department of Internal Medicine, St Joseph Hospital, Veldhoven, Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Dormans
authors.forename: R M
authors.initials: RM
authors.lastname: Huige
authors.forename: P G
authors.initials: PG
authors.lastname: Gerlag
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004487:Edema / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy*; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D005665:Furosemide