Role of different kinds of dialysis in the treatment of refractory heart failure


Cardiorenal syndrome is a severe and potentially lethal disease in which heart and kidney failures coexist. The classic treatment with loop diuretics is ineffective due to the resistance of the kidney to those drugs, which requires the use of other therapies, such as extracorporeal ultrafiltration and peritoneal dialysis. This last technique is useful both in the acute treatment of acute heart decompensation and the chronic management of heart failure, because it improves heart function by reducing the volume overload, which in turn contributes to improving the kidney function with a limited number of side effects, which makes it the technique of choice for the treatment of diuretic-resistant heart failure. In this review, we present a description of the different kinds of cardiorenal syndrome, as well as the different treatments that are used, with special attention to the different modalities of peritoneal dialysis.

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Rosado, C. , Manzanedo, R. , Felipe, C. , Alaguero, B. , Fildago, A. , Chacón, C. and Martín, J. (2014) Role of different kinds of dialysis in the treatment of refractory heart failure. Journal of Biomedical Science and Engineering, 7, 24-27. doi: 10.4236/jbise.2014.71004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Norton, C., Georgiopoulou, V.V., Kalogeropoulos, A.P. and Butler, J. (2011) Epidemiology and cost of advanced heart failure. Progress in Cardiovascular Diseases, 54, 78-85.
[2] Ellison, D.H. (2001) Diuretic therapy and resistance in congestive heart failure. Cardiology, 96, 132-143.
[3] Ronco, C., Haapio, M., House, A.A., Anavekar, N. and Bellomo, R. (2008) Cardiorenal syndrome. Journal of the American College of Cardiology, 52, 1527-1539.
[4] Bock, J.S. and Gottlieb, S.S. (2010) Cardiorenal syndrome: New perspectives. Circulation, 121, 2592-2600.
[5] Nakayama, M., Nakano, H. and Nakayama, M. (2010) Novel therapeutic option for refractory heart failure in elderly patients with chronic kidney disease by incremental peritoneal dialysis. Journal of Cardiology, 55, 49-54.
[6] Courivaud, C., Kazory, A., Crépin, T., Azar, R., Bresson-Vautrin, C., et al. (2013) Peritoneal dialysis reduces the number of hospitalization days in heart failure patients refractory to diuretics. Peritoneal Dialysis International. (not yet published)
[7] Van Der Sande, F.M., Cnossen, T.T., Cornelis, T., Konings, C.J., Kooman, J.P., et al. (2012) Peritoneal dialysis in patients with heart failure. Minerva Urologica e Nefrologica, 64, 163-172.
[8] Nakayama, M. (2013) Nonuremic indication for peritoneal dialysis for refractory heart failure in cardiorenal syndrome type II: Review and perspective. Peritoneal Dialysis International, 33, 8-14.
[9] Rizkallah, J., Sood, M.M., Reslerova, M., Cordova, F., Malik, A., et al. (2013) Reduced hospitalizations in severe, refractory congestive heart failure with peritoneal dialysis: A consecutive case series. Clinical Nephrology, 80, 334-341.
[10] Próchnicka, A., Krzesiński, P., Halas, K., Dziuk, M., Niemczyk, S., et al. (2013) Diuretic-resistant congestive heart failure treated successfully with peritoneal ultra-filtration. Kardiologia Polska, 71, 393-395.
[11] Kagan, A. and Rapoport, J. (2005) The role of peritoneal dialysis in the treatment of refractory heart failure. Nephrology Dialysis Transplantation, 20, vii28-vii31.
[12] Mehrotra, R. and Kathuria, P. (2006) Place of peritoneal dialysis in the management of treatment-resistant congestive heart failure. Kidney International, 70, S67-S71.
[13] Gotloib, L., Fudin, R., Yakubovich, M. and Vienken, J. (2005) Peritoneal dialysis in refractory end-stage congestive heart failure: A challenge facing a nowin situation. Nephrology Dialysis Transplantation, 20, vii32-vii36.
[14] Basile, C., Chimienti, D., Bruno, A., Cocola, S., Libutti, P., Teutonico, A., et al. (2009) Efficacy of peritoneal dialysis with icodextrin in the long-term treatment of refractory congestive heart failure. Peritoneal Dialysis International, 29, 116-118.

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