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Abstract: TH-PO294

Follow -Up and Survival in Refractory Congestive Heart Failure Patients Treated with Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Bozikas, Andreas, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Vakiani, Styliani, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Kitoukidi, Eleni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Kaltzidis, Theotokis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Pozoukidou, Kalliopi, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Martika, Antigoni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Georgilas, Nikolaos, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Pangidis, Panagiotis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Spaia, Sofia, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
Background

Data on survival rates of patients (pts) suffering from Refractory Congestive Heart Failure (RCHF) treated with Peritoneal Dialysis (PD) are limited.
We have previously reported the beneficial effect of PD application for RCHF for a period of 12 months. According to our results body weight, use of diuretics and hospitalisations were decreased, while clinical status and their New York Heart Association (NYHA) class were improved along with cardiac function parameters on Cardiac Echo.
We followed this cohort and evaluated the mortality over a 48 months observational period.

Methods

We had enrolled 18 pts (mean age 82.6 years). Inclusion criteria were NYHA IV symptoms for a 6 months interval with deterioration of renal function. Mean time on PD was 26.7 (6 - 48) months.

Results

Overall, while on PD, 10 pts died (55.5 %) during the 4 year period. Cardiac arrest was the main cause of death (6/10), infections being the second (4/10). Two pts died of complicated urinary tract infection and one of respiratory infection. One patient developed fungal peritonitis, had the PD catheter removed, was transferred to hemodialysis and later died. One patient suffered from Encapsulating Peritoneal Sclerosis and had the PD catheter removed, transferred to hemodialysis and doing well. 7 pts still remain in PD, on good clinical condition and stable body weight. During this period, no hospitalisation was recorded due to RCHF decompensation, in any of the pts.
Mean survival time in PD was 32 months ± SE 4 months.

Conclusion

Cardiac arrest is still the major cause of death in this cohort, however, 40 % of pts died of non cardiovascular causes.
According to literature < 50 % pts with NYHA class IV RCHF, survive 6 months.
Impressively in this cohort mean survival time was 5 times longer indicating that PD not only contributes to life elongation, but also offers better quality.