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Kidney Week

Abstract: TH-PO286

The Beneficial Role of Peritoneal Dialysis on Cardiac Functional Parameters in Patients with Congestive Heart Failure: A 3.5-Year Follow-Up

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Pangidis, Panagiotis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Bozikas, Andreas, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Lazaridou, Fotini, 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
  • Pozoukidou, Kalliopi, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece
  • Stamatopoulou, Evlambia, 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
Background

Peritoneal Dialysis (PD) applied in patients (pts) with congestive heart failure (CHF), resistant to diuretic therapy, results in significant improvement of their condition.
We examined the effect of PD on extended time period, as a continuous ultrafiltration treatment to pts with CHF (NYHA class IV) and renal disease stage > IIIb on cardiac functional parameters.
We performed a detailed Cardiac Ultrasound (CU) in an effort to identify markers to distinguish population that might benefit of early PD application.

Methods

We enrolled 28 pts (mean age 78.3 years) in PD over 42 months (mo). Inclusion criteria were CHF (NYHA class IV) symptoms, resistant to diuretics, and deterioration of renal function. Assessment of cardiac function by CU on the initiation of PD, 6 and 12 mo later. We recorded and evaluated 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 21 ± 10.16 (7 - 42) mo.
Remarkably, significant reduction of all CU parameters, was noted, during period 0 – 6 mo and 6 – 12 mo for every patient. In contrast, no important changes were observed in period 6 – 12 mo.
Also, there was substantial decrease of diuretics, as well as elimination of hospitalizations due to CHF decompensation and noteworthy improvement of NYHA class.
As it was expected we observed significant body weight decrease in period 0 – 6 mo as well as in 0 – 12 months. But, no important changes in period 6 – 12 mo.

Conclusion

The gradual and continuous removal of excess fluid resulted in clinical improvement of the living status of all our pts. Furthermore, there was a long term improvement of the left and right cardiac functional parameters in CU. Thus, dramatically diminishing hospitalizations, due to decompensation of CHF, and restoring pts autonomy.
The application of PD can be an important choice in the management of CHF NYHA class IV. The outcome of this prospective study supports the use of PD in selected pts of this cohort.