title: Prospective study on clinical effects of renal replacement therapy in treatment-resistant congestive heart failure.
abstract: OBJECTIVE
  Clinical outcome in cardiorenal syndrome (CRS) Type 2 and treatment with dialysis.
  
  
  METHODS
  Prospective observational non-randomized study.
  
  
  RESULTS
  Twenty-three patients were included, mean age 66±21 years. Twelve (52%) patients were treated with peritoneal dialysis (PD) and 11 (48%) with intermittent haemodialysis (IHD). Median survival time after start of dialysis was 16 months. Hospitalizations for cardiovascular causes were reduced (1.4±0.6 pre-dialysis versus 0.4±0.6 days/patient/month post-dialysis, P=0.000), without significant changes in hospitalization for all causes (1.8±1.6 versus 2.1±2.9 days/patient/month). New York Heart Association (NYHA) class (3.8±0.4 at start versus 2.4±0.7 after 4 months, P=0.000, versus 2.7±0.9 after 8 months, P=0.001) and quality of life tended to improve (63±21 at start, versus 41±20 after 4 months, versus 51±25 after 8 months; P=0.056). Left ventricular ejection fraction did not change. The number of technical complications associated with dialysis therapy was relatively high in this population.
  
  
  CONCLUSIONS
  After starting dialysis for CRS, hospitalizations for cardiovascular causes were reduced, but not hospitalizations for all causes. Functional NYHA class improved and quality of life tended to improve, without evidence for a change in cardiac function. In this small study, no differences between IHD and PD were observed.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center + , Maastricht, The Netherlands. ncnossen@amphia.nl
authors.forename: Trijntje T
authors.initials: TT
authors.lastname: Cnossen
authors.forename: Jeroen P
authors.initials: JP
authors.lastname: Kooman
authors.forename: Harmen P
authors.initials: HP
authors.lastname: Krepel
authors.forename: Constantijn J A M
authors.initials: CJ
authors.lastname: Konings
authors.forename: Nicole H M K
authors.initials: NH
authors.lastname: Uszko-Lencer
authors.forename: Karel M L
authors.initials: KM
authors.lastname: Leunissen
authors.forename: Frank M
authors.initials: FM
authors.lastname: van der Sande
mesh_terms: D000368:Aged; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D017582:Renal Replacement Therapy; D015996:Survival Rate