標準治療抵抗性心不全に対する腹膜透析：単一施設経験

Peritoneal dialysis (PD) has been reported as a long-term maintenance treatment of refractory congestive heart failure (RCHF). In this study, we aimed to evaluate the outcome of 24 PD patients with RCHF and Stage IV chronic kidney disease. The continuous ambulatory PD program consisted of two or three exchanges daily and one exchange nightly. In the follow-up period, clinical and echocardiographic biochemical findings and the need for hospitalization were recorded. Fifteen patients (66.7%) were male, and the mean age was 62.75 years. Under the PD treatment, the average daily urine volume and ultrafiltration of the patients were 800-1000 mL and 1000-15,000 mL, respectively. Ten patients were followed for 24 months and eight patients were followed for 12 months. During the follow-up period, there was a regression in the New York Heart Association heart failure class (from Class IV to Class II in 18 patients), and a decrease in body weights and an increase in serum sodium levels in all patients. Only two patients were hospitalized for cardiovascular disease over 2 years. During the follow-up period, one patient was transferred to hemodialysis because of peritonitis. In conclusion, in patients with RCHF and chronic renal failure without dialysis, PD in addition to standard treatment may be a safe treatment choice.