Volume control in treatment-resistant congestive heart failure: role for peritoneal dialysis.
Chronic congestive heart failure (HF) has a rising prevalence and increasing impact on health care systems. Current treatment consists of diuretics, renin-angiotensin-aldosterone system blockers, and restriction of salt and fluids. This strategy is often hampered by a drop in effective circulating volume and hence renal perfusion and function, triggering harmful counter regulatory mechanisms. Slow ultrafiltration by peritoneal dialysis (PD) might be an effective treatment strategy to relieve fluid overload without compromising cardiac output and thereby renal function. In this review, we discuss the (patho)physiological mechanisms of the cardiorenal interaction and the current literature on PD strategies in congestive HF.
Department of Internal Medicine, Martini Hospital, Van Swietenplein 1, 9700 RM, Groningen, The Netherlands, k.e.broekman@gmail.com.
K E
KE
Broekman
S J
SJ
Sinkeler
F
F
Waanders
G L
GL
Bartels
G
G
Navis
W M T
WM
Janssen
D001810:Blood Volume / Q000502:physiology*; D059347:Cardio-Renal Syndrome / Q000503:physiopathology* / Q000628:therapy; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D010530:Peritoneal Dialysis / Q000379:methods*