Abstract: SA-PO701

Effect of Peritoneal Dialysis on Cardiac Functional Parameters in Patients with Congestive Heart Failure

Session Information

  • Peritoneal Dialysis - II
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Bozikas, Andreas, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Georgilas, Nikolaos, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Tsounos, Ioannis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Spaia, Sofia, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Pangidis, Panagiotis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Lazaridou, Fotini, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Kitoukidi, Eleni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Kiriakoutzik, Iliana, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Kaltzidis, Theotokis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Pisanidou, Pinelopi, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Vakiani, Stella, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Martika, Antigoni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
Background

Limited data support that peritoneal dialysis (PD) applied in patients (pts) with congestive heart failure (CHF), resistant to diuretic therapy, results in significant improvement of their status. We examined the long term effect of PD, as a continuous ultrafiltration treatment to pts with CHF, NYHA stage IV & Renal Disease stage > IIIb on cardiac functional parameters. We have applied a detailed Cardiac Echo (CE) examination in an effort to identify markers to distinguish population that might benefit of early PD application.

Methods

We enrolled 18 pts (mean age 80.3 years) in PD. Inclusion criteria were NYHA IV class symptoms & deterioration of renal function. Monthly complete biochemical workup & assessment of the cardiac function by (CE) on initiation of PD & 6-12 months later.
We recorded the Ejection Fraction (LVEF), Relative Wall Thickness (RWT), Left Ventricular Mass Index (LV), Ε/Ε', Left Atrium Volume Index (LA), Pulmonary Artery Systolic Pressure (PASP), Tricuspid Annular Plane Systolic Excursion (TAPSE).

Results

Mean time on the method was 10.1 (6-12) months. We observed body weight decrease (p=0.0083), improved eGFR (p=0.026), decrease of bilirubin levels (p=0.0475), substantial decrease of diuretics, as well as elimination of hospitalizations due to CHF decompensation & remarkable improvement of NYHA class. Significant reductions of LA and LV (p<0.05) were noted in every patient. The rest of the parameters remained unaffected. LVEF showed equivocal changes. One pts died on the 8th month of therapy due to sudden death.

Conclusion

All pts demonstrated clinical improvement of their living status, as a result of the gradual & continuous removal of excess fluid.
Therefore, dramatically diminishing hospitalizations, due to cardiac events, & restoring pts autonomy. Furthermore, there was an improvement of left cardiac function.
However, markers of right cardiac function did not change, probably due to technical or individualized causes. For the same reasons interpretation of LVEF changes is ambiguous & cannot be used as an objective marker to identify this population. The results of this prospective, but small sized, study encourage the application of PD in selected pts with CHF.