RESUMO
Peritoneal dialysis is a renal replacement therapy indicated in patients with an unstable hemodynamic status. It has been used, by ultrafiltration, preferably in those patients with congestive heart failure refractory to conventional medical therapy. We present the experience of our center with five patients who were affected by severe congestive heart failure [Class IV on the New York Heart Association (NYHA) scale] and diverse stages of chronic renal failure, who received this therapy. Icodextrin has been used as an osmotic agent to induce ultrafiltration. The follow-up period ranged between 5 and 14 months (9.8 +/- 3.7 months). The results that we have found are similar to those of other studies: we observed a significant improvement in quality of life and a reduction in morbidity and hospitalization rates in all our patients. But it seems to be necessary to make a prospective randomized controlled trial with more number of individuals to confirm these promising facts, to clarify the impact on the survival, and to analyze the cost-benefit for treating patients suffering from refractory, end stage congestive heart failure.
Assuntos
Insuficiência Cardíaca/terapia , Falência Renal Crônica/terapia , Diálise Peritoneal , Idoso , Feminino , Insuficiência Cardíaca/complicações , Humanos , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
La diálisis peritoneal es una técnica sustitutiva de la función renal indicada en pacientes con inestabilidad hemodinámica. Por ello, se ha utilizado preferentemente en aquellos pacientes con insuficiencia cardíaca refractaria al tratamiento médico convencional. Presentamos la experiencia de nuestro centro con cinco pacientes que presentaban diversos grados de enfermedad renal crónica e insuficiencia cardíaca congestiva, que recibieron este tratamiento. Los resultados que hemos encontrado son superponibles a otros estudios realizados: en todos nuestros pacientes mejoró la clase funcional según la Clasificación de la New York Heart Association y disminuyeron los tiempos de hospitalización. Parece necesario realizar estudios prospectivos con mayor número de individuos para confirmar estas afirmaciones, aclarar el impacto sobre la supervivencia, y analizar el coste-beneficio
Peritoneal dialysis is a renal replacement therapy indicated in patients with an unstable hemodynamic status. It has been used, by ultrafiltration, preferably in those patients with congestive heart failure refractory to conventional medical therapy.We present the experience of our center with five patients who were affected by severe congestive heart failure [Class IV on the New York Heart Association (NYHA) scale] and diverse stages of chronic renal failure,who received this therapy. Icodextrin has been used as an osmotic agent to induce ultrafiltration. The follow-up period ranged between 5 and 14 months (9.8 ± 3.7 months). The results that we have found are similar to those of other studies:we observed a significant improvement in quality of life and a reduction in morbidity and hospitalization rates in all our patients. But it seems to be necessary to make a prospective randomized controlled trial with more number of individuals to confirm these promising facts, to clarify the impact on the survival, and to analyze the cost-benefit for treating patients suffering from refractory, end stage congestive heart failure
