Peritoneal dialysis in patients with congestive heart failure.
BACKGROUND
Peritoneal dialysis (PD) may be a useful technique in the treatment of patients with congestive heart failure, both with and without primary end-stage renal disease (ESRD).


METHODS
In the treatment of patients with ESRD and congestive heart failure (CHF), PD has theoretical advantages compared with haemodialysis (HD), such as the absence of an arteriovenous fistula and the more gradual fluid removal. In cohort studies, the incidence of heart failure was less as compared with HD, however, randomized studies on this aspect are lacking.


RESULTS
As an acute rescue treatment of patients with treatment refractory heart failure, functional improvement has been observed with the use of PD. However, fluid removal is less predictable compared with continuous haemofiltration therapies.


CONCLUSIONS
As a long-term option for patients with treatment refractory CHF without ESRD, various case series showed improved functional performance and a reduction in hospitalization with the use of PD. However, also with the use of PD, median survival is still limited in these patients. Randomized studies are needed to establish the potential role of PD for this indication.
Cnossen
Nynke
N
Department of Nephrology, Academic Hospital Maastricht, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
Kooman
Jeroen P
JP
Konings
Constantijn J
CJ
van Dantzig
Jan-Melle
JM
van der Sande
Frank M
FM
Leunissen
Karel
K
D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D010530:Peritoneal Dialysis