Automated peritoneal dialysis could rapidly improve left heart failure by increasing peritoneal dialysis ultrafiltration: a single-center observational clinical study

Ultrafiltration failure (UFF) is a major cause of water retention, left heart failure (LHF), and peritoneal dialysis (PD) failure. Automated peritoneal dialysis (APD) might have better ultrafiltration (UF) than continuous ambulatory peritoneal dialysis (CAPD). Here. we have studied whether short-term APD could increase UF and improve LHF. 47 patients were included in this study from December 1, 2015, to January 1, 2017. All patients had been treated with CAPD before they came to our center and were treated with APD in the hospital. 24-hour peritoneal UF volume, 24-hour urine volume, body weight, blood pressure, LHF class, serum creatinine, blood urea nitrogen, albumin, potassiwn, hemoglobin, and glucose were collected and compared before and after receiving short-time APD. A total of 47 patients (31 men, mean age 46.8 +/- 16.2 years, mean duration 26 months (2 - 195 months)) were enrolled in this study. Of the 47 patients, peritoneal dialysis UF was significantly increased when receiving short-term APD compared to CAPD (1,261.9 +/- 329.6 mL vs. 706.2 +/- 222.3 mL, p < 0.001), and body weights had significantly decreased 3 days after treatment with APD (57.73 +/- 10.5 vs. 59.81 +/- 10.8, p < 0.001). LHF class was significantly decreased 3 days after receiving APD (1.7 +/- 0.8 vs. 2.4 +/- 1.0, p < 0.001). Blood pressure was well controlled 3 days after treatment with APD (146.6 +/- 14.4 vs. 162.5 +/- 23.8 of SBP, p= 0.007, and 85.6 +/- 11.1 vs. 95.6 +/- 14.7 of DBP, p = 0.001). In conclusion, short-term APD could significantly increase ultrafiltration, rapidly alleviate edema and improve LHF, and might be an effective method to treat UFF and LHF in PD patients.