Peritoneal Dialysis in Refractory End-Stage Congestive Heart Failure

Abstract

We present a study of the patients of CHF with chronic kidney disease who were on peritoneal dialysis for the indication that the patients had become resistant to diuretics with worsening renal function and electrolyte abnormalities. The patients of CHF with chronic kidney disease were initiated on peritoneal dialysis (PD) for the indication of diuretic resistance. Patients with congestive heart failure with New York Heart Association class III and IV and chronic kidney disease stage 4 or above were placed on peritoneal dialysis. All patients were followed for at least one year. . On echocardiography two parameters were particularly estimated, the ejection fraction and stroke volume index. Out of seven patients, five underwent, percutaneous peritoneal dialysis catheter placement by the team of nephrologists. These five patients were considered unfit for general anaesthesia. The other two underwent catheter placement by a surgeon by laparoscopy under general anaesthesia. Our patients displayed, after initiation of PD, an improvement in the ejection fraction and stroke volume index with preserved residual renal function. The mean numbers of days of hospitalization were reduced after initiation of PD. In our study all patients stopped loop diuretics. The three averments of utility of peritoneal dialysis in patients of refractory congestive heart failure were, fewer hospital days of admission, improvement in heart function and preservation of renal function and peritonitis was similar to that of patients who underwent PD for ESRD. Our patients proved that these averments were correct.