Peritoneal ultrafiltration in older adult patients with advanced heart failure

Advanced heart failure (HF) with congestive symptoms refractory to diuretic treatment worsens the patient's prognosis and quality of life. Peritoneal ultrafiltration (PUF) attempts to improve symptoms and reduce HF-related events. This study analyzes the impact of PUF on older adult patients with significant comorbidity and advanced HF. Eighteen patients with advanced HF attended to in the Internal Medicine HF Unit of the Lucus Augusti University Hospital of Lugo, Spain, who started PUF between 2014 and 2021 were analyzed. The number of admissions and instances in which diuretic rescue treatment was used in the year before and after starting PUF were compared. The evolution of renal function, complications secondary to the technique, and survival were also analyzed. The median age was 80 (SD 5.8) years and 72.2% were men. Comparing the year after starting PUF to the year before starting PUF, hospital admissions due to HF (4 vs 20, p = 0.01) and the use of intravenous diuretic rescue treatment declined (4 vs 118, p < 0.001). There was no significant deterioration in renal function during the first year of follow-up or major complications associated with the technique. Survival was 72% at 1 year. In older adult patients with comorbidity, advanced HF, and refractory congestive symptoms, PUF reduced hospital admissions and the use of intravenous diuretic rescue treatment, without major complications.