title: Peritoneal dialysis reduces the number of hospitalization days in heart failure patients refractory to diuretics.
abstract: BACKGROUND
  Previous small studies have reported favorable results of peritoneal dialysis (PD) in the setting of chronic refractory heart failure (CRHF). We evaluated the impact of PD in a larger cohort of patients with CHRF where end-stage renal disease was excluded. ♢
  
  
  METHODS
  All patients who received PD therapy for CRHF between January 1995 and December 2010 in two medical centers in France were included in this retrospective study. Baseline characteristics were compared with clinical parameters during the first year after initiation of PD. Mortality, safety, and sustainability of PD were also analyzed. ♢
  
  
  RESULTS
  The 126 patients included had a mean age of 72 ± 11 years and an estimated glomerular filtration rate of 33.5 ± 15.1 mL/min/1.73 m2. Mean time on PD was 16 ± 16.6 months. During the first year, patients with a left ventricular ejection fraction (LVEF) of 30% or less experienced improvement in cardiac function (30% ± 10% vs 20% ± 6%, p < 0.0001). We observed a significant reduction in the number of days of hospitalization for acute decompensated heart failure after PD initiation (3.3 ± 2.6 days/patient-month vs 0.3 ± 0.5 days/patient-month, p < 0.0001). One-year mortality was 42%. ♢
  
  
  CONCLUSIONS
  In CRHF, PD significantly reduces the number of days of hospitalization for acute heart failure. Improved LVEF may have led to the comparatively good 1-year survival in this cohort.
authors.affiliation: Department of Nephrology, Dialysis, and Renal Transplantation,1 University of Franche-Comté, Besançon, France;
authors.forename: Cécile
authors.initials: C
authors.lastname: Courivaud
authors.forename: Amir
authors.initials: A
authors.lastname: Kazory
authors.forename: Thomas
authors.initials: T
authors.lastname: Crépin
authors.forename: Raymond
authors.initials: R
authors.lastname: Azar
authors.forename: Catherine
authors.initials: C
authors.lastname: Bresson-Vautrin
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chalopin
authors.forename: Didier
authors.initials: D
authors.lastname: Ducloux
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D004232:Diuretics
keywords: Cardiorenal syndrome; cardiac failure; impaired renal function; ultrafiltration