title: Peritoneal dialysis as a successful treatment in patients with refractory congestive heart failure: a one-center experience.
abstract: BACKGROUND
  Ultrafiltration (UF) technique is a valuable alternative to pharmacological therapy in the treatment of patients with refractory congestive heart failure (HF). The aim of this study was to describe a single-center experience in the treatment of refractory HF patients with peritoneal dialysis (PD).
  
  
  METHODS
  Retrospective study of 5 patients included in a single PD Unit, showing symptoms and signs of severe refractory congestive HF to optimal pharmacological therapy (NYHA class IV). Clinical and laboratory parameters, survival, hospitalization, and peritonitis rates were recorded.
  
  
  RESULTS
  Patients were followed for 9.36 (± 6.36) months; population mean age was 62 (± 16) years and Charlson's comorbidity index was 7.2 (± 2.1). After PD therapy, functional class of NYHA significantly improved (class IV to class II in 4 patients). Doppler-echocardiography improved in terms of ejection fraction (EF) or systolic pressure of the pulmonary artery (SPPA) in 3 patients. No patient was readmitted due to HF. Hospitalization days substantially decreased in 4 patients. One patient presented with peritonitis episodes. Three patients died but the mean survival was higher than expected according to their comorbidity index.
  
  
  CONCLUSIONS
  PD, applied to refractory HF in addition to optimal pharmacological therapy, improves quality of life and functional class and reduces hospitalization days due to HF.
authors.forename: Sara
authors.initials: S
authors.lastname: Querido
authors.forename: Patrícia
authors.initials: P
authors.lastname: Branco
authors.forename: Henrique
authors.initials: H
authors.lastname: Sousa
authors.forename: Teresa
authors.initials: T
authors.lastname: Adragão
authors.forename: Carlos
authors.initials: C
authors.lastname: Aguiar
authors.forename: Sara
authors.initials: S
authors.lastname: Pereira
authors.forename: Elisabete
authors.initials: E
authors.lastname: Costa
authors.forename: Augusta
authors.initials: A
authors.lastname: Gaspar
authors.forename: José Diogo
authors.initials: JD
authors.lastname: Barata
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D013318:Stroke Volume; D015996:Survival Rate; D017211:Treatment Failure