Tidal peritoneal dialysis versus ultrafiltration in type 1 cardiorenal syndrome: A prospective randomized study.
Acute Disease
Cardio-Renal Syndrome
/ blood
Creatinine
/ analysis
Female
Heart Failure
/ diagnosis
Humans
Kidney Failure, Chronic
/ blood
Male
Middle Aged
Outcome and Process Assessment, Health Care
Patient Readmission
/ statistics & numerical data
Peritoneal Dialysis
/ adverse effects
Prospective Studies
Stroke Volume
Ultrafiltration
/ adverse effects
Tidal peritoneal dialysis
cardiorenal syndrome type 1
diuresis
dyspnea score
end-stage renal disease
ultrafiltration
Journal
The International journal of artificial organs
ISSN: 1724-6040
Titre abrégé: Int J Artif Organs
Pays: United States
ID NLM: 7802649
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
pubmed:
16
7
2019
medline:
12
2
2020
entrez:
16
7
2019
Statut:
ppublish
Résumé
Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of peritoneal dialysis in patients with acute decompensated heart failure complicated by acute cardiorenal syndrome. We randomly assigned a total of 88 patients with type 1 acute cardiorenal syndrome to a strategy of ultrafiltration therapy (44 patients) or tidal peritoneal dialysis (44 patients). The primary endpoint was the change from baseline in the serum creatinine level and left ventricular function represented as ejection fraction, as assessed 72 and 120 h after random assignment. Patients were followed for 90 days after discharge from the hospital. Ultrafiltration therapy was inferior to tidal peritoneal dialysis therapy with respect to the primary endpoint of the change in the serum creatinine levels at 72 and 120 h ( Tidal peritoneal dialysis is a safe and effective means for removing toxins and large quantities of excess fluid from patients with intractable heart failure. In patients with cardiorenal syndrome type 1, the use of tidal peritoneal dialysis was superior to ultrafiltration therapy for the preservation of renal function, improvement of cardiac function, and net fluid loss. Ultrafiltration therapy was associated with a higher rate of adverse events.
Sections du résumé
BACKGROUND
BACKGROUND
Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of peritoneal dialysis in patients with acute decompensated heart failure complicated by acute cardiorenal syndrome.
METHODS
METHODS
We randomly assigned a total of 88 patients with type 1 acute cardiorenal syndrome to a strategy of ultrafiltration therapy (44 patients) or tidal peritoneal dialysis (44 patients). The primary endpoint was the change from baseline in the serum creatinine level and left ventricular function represented as ejection fraction, as assessed 72 and 120 h after random assignment. Patients were followed for 90 days after discharge from the hospital.
RESULTS
RESULTS
Ultrafiltration therapy was inferior to tidal peritoneal dialysis therapy with respect to the primary endpoint of the change in the serum creatinine levels at 72 and 120 h (
CONCLUSION
CONCLUSIONS
Tidal peritoneal dialysis is a safe and effective means for removing toxins and large quantities of excess fluid from patients with intractable heart failure. In patients with cardiorenal syndrome type 1, the use of tidal peritoneal dialysis was superior to ultrafiltration therapy for the preservation of renal function, improvement of cardiac function, and net fluid loss. Ultrafiltration therapy was associated with a higher rate of adverse events.
Identifiants
pubmed: 31303099
doi: 10.1177/0391398819860529
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM