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Review
. 2015 Apr;5(2):145-56.
doi: 10.1159/000380915.

Peritoneal dialysis in patients with refractory congestive heart failure: a systematic review

Renhua Lu  1 , María-Jimena Muciño-Bermejo  2 , Leonardo Claudino Ribeiro  2 , Enrico Tonini  2 , Carla Estremadoyro  2 , Sara Samoni  2 , Aashish Sharma  2 , José de Jesús Zaragoza Galván  2 , Carlo Crepaldi  2 , Alessandra Brendolan  2 , Zhaohui Ni  3 , Mitchell H Rosner  4 , Claudio Ronco  2
Affiliations
Review

Peritoneal dialysis in patients with refractory congestive heart failure: a systematic review

Renhua Lu et al. Cardiorenal Med. 2015 Apr.

Abstract

Background: Refractory congestive heart failure (RCHF) is associated with a high mortality rate and is a major contributor to hospital admissions. Peritoneal dialysis (PD) is an option to control volume overload and perhaps improve outcomes in this challenging patient population. The aim of this systematic review is to describe the relative risk-benefit ratio based on data reported regarding the use of PD in RCHF. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. An electronic search of PubMed, Embase, and the Cochrane Library was performed to identify relevant studies published from January 1951 to February 2014. Eligible studies selected were prospective or retrospective adult population studies on PD in the setting of RCHF. The following clinical outcomes were used to assess PD therapy: (1) hospitalization rates; (2) heart function; (3) renal function; (4) fluid overload, and (5) adverse clinical outcomes.

Summary: Of 864 citations, we excluded 843 citations and included 21 studies (n = 673 patients). After PD, hospitalization days declined significantly (p = 0.0001), and heart function improved significantly (left ventricular ejection fraction: p = 0.0013; New York Heart Association classification: p = 0.0000). There were no statistically significant differences in glomerular filtration rate after PD treatment in non-chronic kidney disease stage 5D patients (p = 0.1065). Among patients treated with PD, body weight decreased significantly (p = 0.0006). The yearly average peritonitis rate was 14.5%, and the average yearly mortality was 20.3%.

Key messages: This systematic review suggests that PD may be an effective and safe therapeutic tool for patients with RCHF.

Keywords: Extracorporeal ultrafiltration; Glomerular filtration rate; Heart function; Hospitalization days.

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Figures

Fig. 1
Fig. 1
Flow chart of article selection (PRISMA 2009 Flow Diagram).
Fig. 2
Fig. 2
The difference in hospitalization days between pre- and post-PD treatment.
Fig. 3
Fig. 3
The difference in LVEF between pre- and post-PD treatment.
Fig. 4
Fig. 4
The difference in GFR between pre- and post-PD treatment based on non-CKD5D patients.
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See this image and copyright information in PMC

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