Could Peritoneal Dialysis be an Option for the Treatment of Congestive Heart Failure?

Objective: Heart failure is a progressive and fatal disease even with appropriate treatment. Hypervolemia is a major cause of mortality and hospital admissions in these patients. Peritoneal dialysis has been successfully used for volume control in congestive heart failure patients with diuretic resistance in recent years. The present study aims to assess the effects of peritoneal dialysis on refractory heart failure. Methods: The 2-year follow-up data of 12 heart failure patients with reduced ejection fraction who had undergone peritoneal dialysis at our center between 2014 and 2019 were retrospectively analyzed in 3-month periods. The effects of peritoneal dialysis on functional status, echocardiography, physical and biochemical parameters, hospital admission, and mortality rates were assessed. Results: Functional capacity improved significantly (P =.005). When the sixth month was reached, no patient remained in the New York Heart Association class 4. A significant improvement was observed in mean arterial pressure (75.3 +/- 17 vs. 91.3 +/- 16.6; P =.005). There was an improvement in congestive symptoms (dyspnea, pleural effusion, and pretibial edema; P =.037; P =.0002; P =.005, respectively). Although statistical significance could not be reached, ejection fraction on echocardiography was found to increase (28.7% +/- 12% vs. 37% +/- 12%; P =.113). Despite statistical significance was not reached, there was a trend for an increase in hematocrit, serum albumin, and sodium levels and a decrease in uric acid level. The 1-year and 2-year mortality rates were 41.7% and 58.3%, respectively. Conclusion: In heart failure patients with reduced ejection fraction with diuretic resistance, peritoneal dialysis improves congestive symptoms, improves functional capacity, and offers a treatment option in addition to pharmacological therapy.