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Abstract: TH-PO418

Peritoneal Ultrafiltration on Refractory Heart Failure

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Becerra-Gamba, Tomas Alexis, Instituto Nacional de Cardiología, Mexico City, Mexico City, Mexico
  • Leal, Gabriela, Instituto Nacional de Cardiología, México, Mexico
  • Moguel, Bernardo, Instituto Nacional de Cardiologia, Mexico City, COYOACAN, Mexico

Group or Team Name

  • Instituto Nacional de Cardiología "Ignacio Chávez"
Background

Fluid Overload (FO) in Heart Failure (HF) is a major risk factor for morbidity and mortality.

Methods

The primary outcome of this study was to evaluate the safety and efficacy of Icodextrin for peritoneal ultrafiltration in Refractory HF (RHF) patients with FO and to assess the change in New York Heart Association (NHYA) Class, body composition measurement by electrical bio-impedance, length of hospital stay (LHS) and hospital costs (HC) in a 1 year follow up.

Results

we included a total of 6 patients with RHF and FO, table 1 shows baseline and post-intervention characteristics of participants. During the follow up we registered 1 episode of peritonitis and 1 mechanical dysfunction of peritoneal catheter. The median of LHS in one year previous treatment was 35 (RIC 23-50) vs 3 (RIC 2-25) days in 1 year follow-up (p 0.07). Also, a 1 year HC pre-intervention was $6,804.82 (RIC $4,308.62 - 11,579.14) vs $676.56 (RIC $420.69 –4,093.65) US dollars (p 0.06). At 6 months follow up we registered 2 deaths (34%).

Conclusion

we observed a better FO control and an improvement of symptoms (NYHA class), also a decrease of LHS and HC. The limitation of this study is the sample size but with a tendency towards statistical significance.

Baseline and Post-intervention characteristics
Patients characteristics (n=6)Baseline6 months
Female n (%)3 (50) 
Age (yr)62 ± 6.4 
Primary Cause of HF
Ischemic Cardiomyopathy n (%)
Valvulopathy n (%)
4 (67)
5 (83)
 
Major co-morbidities
Pulmonary Hypertension n (%)
DM2 n (%)
Arterial Hypertension n (%)
Liver Failure n (%)
3 (50)
1 (17)
1 (17)
2 (34)
 
Diuresis (mL/day)920 ± 259 
NT-Pro Brain Natriuretic Peptide (pg/mL)14359 ± 10313 
Left Ventricular Ejection Fraction (%)45 ±17 
NYHA Class
II n (%)
III n (%)
IV n (%)
0
0
0
6 (100)
(p=0.01)
4 (67)
2 (33)
Glomerular Filtration Rate - CKD Epi (mL/min/1.73 m2)22.6 ± 13.434.5 ± 23.3
Laboratory:
Blood Urine Nitrogen (mg/dL)
Potassium (mEq/L)
Albumin (g/dL)
55.4 ± 28
4.1 ± 0.4
3.9 ± 0.6
48 ± 14.3
4.4 ± 0.8
3.5 ± 0.3
Overhydration (L)3.9 ± 1.32.7 ± 1.4 (p 0.09)