title: Peritoneal dialysis in patients with refractory congestive heart failure: a systematic review.
abstract: BACKGROUND
  Refractory congestive heart failure (RCHF) is associated with a high mortality rate and is a major contributor to hospital admissions. Peritoneal dialysis (PD) is an option to control volume overload and perhaps improve outcomes in this challenging patient population. The aim of this systematic review is to describe the relative risk-benefit ratio based on data reported regarding the use of PD in RCHF. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. An electronic search of PubMed, Embase, and the Cochrane Library was performed to identify relevant studies published from January 1951 to February 2014. Eligible studies selected were prospective or retrospective adult population studies on PD in the setting of RCHF. The following clinical outcomes were used to assess PD therapy: (1) hospitalization rates; (2) heart function; (3) renal function; (4) fluid overload, and (5) adverse clinical outcomes.
  
  
  CONCLUSIONS
  Of 864 citations, we excluded 843 citations and included 21 studies (n = 673 patients). After PD, hospitalization days declined significantly (p = 0.0001), and heart function improved significantly (left ventricular ejection fraction: p = 0.0013; New York Heart Association classification: p = 0.0000). There were no statistically significant differences in glomerular filtration rate after PD treatment in non-chronic kidney disease stage 5D patients (p = 0.1065). Among patients treated with PD, body weight decreased significantly (p = 0.0006). The yearly average peritonitis rate was 14.5%, and the average yearly mortality was 20.3%.
  
  
  CONCLUSIONS
  This systematic review suggests that PD may be an effective and safe therapeutic tool for patients with RCHF.
authors.affiliation: Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Renhua
authors.initials: R
authors.lastname: Lu
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: María-Jimena
authors.initials: MJ
authors.lastname: Muciño-Bermejo
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Leonardo Claudino
authors.initials: LC
authors.lastname: Ribeiro
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tonini
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Estremadoyro
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Samoni
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Aashish
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: José de Jesús
authors.initials: Jde J
authors.lastname: Zaragoza Galván
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Crepaldi
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brendolan
authors.affiliation: Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Division of Nephrology, University of Virginia Health System, Charlottesville, Va., USA.
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Rosner
authors.affiliation: Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
keywords: Extracorporeal ultrafiltration; Glomerular filtration rate; Heart function; Hospitalization days