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Role of Peritoneal Ultrafiltration in Heart Failure Treatment
Ist Teil von
Haseki tıp bülteni, 2017-09, Vol.55 (3), p.165-174
Ort / Verlag
Istanbul: Haseki Eğitim ve Araştırma Hastanesi
Erscheinungsjahr
2017
Quelle
EZB Free E-Journals
Beschreibungen/Notizen
Cardiorenal syndrome (CRS) is a general term that can
reflect different clinical conditions in which cardiac and renal
dysfunctions coexist. The main pathogenetic mechanisms
playing a role in heart failure (HF) and CRS are neurohumoral
adaptation, right ventricular dilatation and dysfunction and
systemic inflammation. Persistence of these factors cause
focal and segmental glomerulosclerosis, and tubulointerstitial
fibrosis in the renal parenchyma. Diuretics, beta blockers, reninangiotensin-
aldosterone system inhibitors, and vasodilators are
the main medical treatments besides conventional approach,
such as salt and water restriction and quitting smoking,
in HF treatment. Diuretic resistance is the main problem
emerging during diuretic treatments. Two renal replacement
treatments have become prominent for removal of excess
fluids via ultrafiltration in HF patients with diuretic resistance
extracorporeal ultrafiltration with hemodialysis and peritoneal
dialysis (PD). Herein, the role of these two ultrafiltration
modalities, especially peritoneal ultrafiltration (PUF) in the
treatment of HF is discussed. The main studies and advantages
of PUF in HF treatment were discussed. Moreover, effects of
PD on glomerular filtration rate, hospitalization and mortality
were investigated. In conclusion, PD is an alternative cheap,
practical and convenient therapy in reducing cardiac volume
burden in HF patients who do not respond well to standard
treatments and/or require frequent hospitalization.