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Abstract: PO1312

Peritoneal Ultrafiltration Is Associated with Improvement of Functional Class in Patients with Congestive Heart Failure

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Chamarthi, Gajapathiraju, University of Florida College of Medicine, Gainesville, Florida, United States
  • Singh, Amardeep, University of Florida College of Medicine, Gainesville, Florida, United States
  • Bejjanki, Harini, University of Florida College of Medicine, Gainesville, Florida, United States
  • Kazory, Amir, University of Florida College of Medicine, Gainesville, Florida, United States
Background

Congestion is considered an integral component of heart failure syndrome and is a key driver of adverse outcomes. Peritoneal ultrafiltration (PUF) has emerged as an efficient therapeutic modality for management of fluid overload in patients with congestive heart failure (CHF) without end-stage kidney disease (ESKD). The efficacy of therapies of CHF are conventionally assessed through their effect on New York Heart Association (NYHA) classification. We sought to explore the reported impact of PUF on functional class of these patients.

Methods

Articles cited in PubMed database using keywords “heart failure”, “peritoneal ultrafiltration”, and “peritoneal dialysis” were searched. Available data from contemporary clinical trials of PUF in patients with CHF (without ESKD) that were performed between January 2010 and August 2019, and included more than 20 patients were selected and reviewed. Those trials evaluating the impact of PUF on NYHA functional class were included. Pertinent data were extracted and recorded.

Results

Out of 10 clinical studies meeting the criteria, 4 did not have the needed data on NYHA class; 6 studies (3 retrospective and 3 prospective) with a total of 408 participants and a mean age of 71.9 were included. The pre-PUF mean left ventricular ejection fraction and weight were 34.4% and 78.6 Kg respectively. The median follow up was 13.7 months. There was substantial variation in the reporting of time point for various endpoints. These studies unanimously reported improvement in NYHA functional class, which was close to -1 class for those that assessed the entire study population.

Conclusion

Available data based on contemporary clinical trials suggests that PUF, when used for management of patients with CHF, is associated with improvement of functional class. This finding is in keeping with our previous report on the salutary impact of PUF on volume status of these patients. Future controlled studies are needed to explore whether these benefits would translate into improved survival.