Abstract: TH-PO418
Peritoneal Ultrafiltration on Refractory Heart Failure
Session Information
- Dialysis: Peritoneal Dialysis - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
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) | Baseline | 6 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 ± 13.4 | 34.5 ± 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 ± 1.3 | 2.7 ± 1.4 (p 0.09) |