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Peritoneal ultrafiltration in end-stage chronic heart failure
Hanna Fröhlich1, Hugo A Katus1, Tobias Täger1
1Department of Cardiology , University Hospital Heidelberg , Heidelberg , Germany.
Clinical Kidney Journal
|March 28, 2015
Summary
Peritoneal ultrafiltration (pUF) improved clinical status in end-stage chronic heart failure (CHF) patients with cardiorenal syndrome type 2 (CRS-2). While not reducing mortality, pUF significantly enhanced quality of life and reduced hospitalizations.
Area of Science:
- Cardiology
- Nephrology
- Critical Care Medicine
Background:
- Cardiorenal syndrome type 2 (CRS-2) is prevalent in end-stage chronic heart failure (CHF).
- Peritoneal ultrafiltration (pUF) offers potential for functional improvement and reduced hospitalizations in these patients.
Purpose of the Study:
- To evaluate the efficacy of ambulatory peritoneal ultrafiltration (pUF) in end-stage chronic heart failure (CHF) patients with cardiorenal syndrome type 2 (CRS-2).
- To assess the impact of pUF on hospitalization rates, mortality, and clinical parameters over a 1-year period.
Main Methods:
- A prospective study of 39 end-stage CHF patients with CRS-2 initiated on ambulatory pUF.
- Comparison of outcomes with pretreatment data and a matched control group receiving standard medical treatment.
- Primary endpoint: all-cause hospitalization; Secondary endpoints: mortality, treatment alterations, weight, NYHA class, and quality of life.
Main Results:
- pUF showed a trend towards reduced 1-year hospitalization days (P=0.07).
- Significant improvements observed in volume overload (P<0.05), NYHA functional class (P<0.001), and mental health (P<0.05) with pUF.
- Hospitalization days for all causes and cardiovascular causes were significantly reduced (P<0.05 and P<0.001, respectively) during interim periods.
Conclusions:
- Ambulatory peritoneal ultrafiltration (pUF) effectively improves the clinical condition of end-stage CHF patients with CRS-2.
- Further randomized controlled trials are necessary to definitively establish the effects of pUF on hospitalization and mortality in this patient population.
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