Peritoneal dialysis in heart failure: focus on kidney and ventricular dysfunction

Area of Science:

• Cardiology
• Nephrology
• Renal Replacement Therapy

Background:

• Heart failure is a global health issue with advanced stages presenting significant management challenges.
• Diuretic resistance, kidney dysfunction, and refractory congestion are common complications in advanced heart failure.
• Ultrafiltration via hemodialysis or peritoneal dialysis offers options for fluid overload management.

Purpose of the Study:

• To review current evidence on peritoneal dialysis for heart failure patients with diuretic resistance.
• To explore benefits across varying ventricular and renal dysfunction.
• To identify knowledge gaps and the need for further research.

Main Methods:

• Review of contemporary evidence on peritoneal dialysis in heart failure.
• Analysis of studies across the spectrum of ventricular dysfunction.
• Examination of data concerning different degrees of renal dysfunction.

Main Results:

• Peritoneal dialysis shows potential benefits including improved functional class, reduced hospital admissions, enhanced quality of life, and decreased mortality.
• Existing evidence is largely from observational studies with limited patient numbers.
• Optimal timing and patient subgroups for peritoneal dialysis remain unclear.

Conclusions:

• Peritoneal dialysis is a promising option for fluid management in advanced heart failure.
• Further high-quality research, particularly randomized controlled trials, is essential.
• Clarifying the role and optimal application of peritoneal dialysis in heart failure is a priority.