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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Peritoneal dialysis and heart failure.

Caroline M Hsu1, Daniel E Weiner, Wendy McCallum

  • 1Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.

Current Opinion in Nephrology and Hypertension
|October 21, 2025
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Summary

Peritoneal dialysis effectively manages fluid overload in patients with heart failure and kidney failure. Increased provider education and support are needed to overcome challenges and improve its underutilization.

Keywords:
end-stage kidney diseasehealth systemsheart failurehome dialysisperitoneal dialysis

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Area of Science:

  • Nephrology and Cardiology
  • Renal Replacement Therapies

Background:

  • Heart failure (HF) and chronic kidney disease (CKD) frequently coexist.
  • Both conditions involve salt and water retention, leading to clinical decline.
  • Peritoneal dialysis (PD) is effective for fluid overload but underused in HF patients.

Purpose of the Study:

  • To review the application of peritoneal dialysis in heart failure management.
  • To explore the benefits and challenges of PD for comorbid HF and CKD.

Main Methods:

  • Literature review on peritoneal dialysis in heart failure patients.
  • Analysis of PD's efficacy in fluid management and hemodynamic stability.
  • Examination of challenges to PD implementation in this population.

Main Results:

  • Peritoneal dialysis offers effective volume removal with hemodynamic stability compared to intermittent hemodialysis.
  • PD reduces the risk of systemic bloodstream infections, crucial for patients with cardiac devices.
  • Systemic and logistical barriers, including urgent initiation and clinician inexperience, hinder widespread PD adoption.

Conclusions:

  • Peritoneal dialysis is an effective treatment for heart failure in patients with kidney failure.
  • Underutilization persists due to systemic and logistical challenges.
  • Strategies to increase PD uptake involve provider education and enhanced structural/logistic support, especially in hospitals.