IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203075
Open Access Review
Peritoneal dialysis in heart failure: focus on kidney and ventricular dysfunction
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1 Heart Failure Unit, Department of Cardiology, Hospital del Mar, 08003 Barcelona, Spain
2 Department of Nephrology, Hospital del Mar, 08003 Barcelona, Spain
3 Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
4 Heart Diseases Biomedical Research Group (GREC), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
Academic Editor: Peter A. McCullough
Rev. Cardiovasc. Med. 2021, 22(3), 649–657;
Submitted: 2 June 2021 | Revised: 5 July 2021 | Accepted: 12 July 2021 | Published: 24 September 2021

Heart failure is a significant health problem worldwide. Despite all the new therapies available nowadays, many patients will reach advanced stages of the disease. Diuretic resistance, kidney dysfunction, and refractory congestion, all highly prevalent in advanced heart failure, frequently complicate the situation, making it more challenging to manage. Ultrafiltration through hemodialysis or peritoneal dialysis can be alternative options to treat fluid overload. Peritoneal dialysis has gained increased interest in the last decades due to several benefits such as functional class improvement, reduction in hospital admissions, improvement in quality of life, and even a reduction in mortality shown by numerous cohort studies. However, the majority of the studies were observational and with a limited number of patients. In addition, the optimal timing for the initiation of this type of therapy and the subgroup of patients who would benefit the most from it is unknown. Hence, randomized controlled trials in this subject are urgently needed. We aim to review the contemporary evidence of peritoneal dialysis in patients with heart failure and diuretic resistance across the spectrum of ventricular dysfunction and degree of renal dysfunction.

Peritoneal dialysis
Heart failure
Diuretic resistance
Fluid overload
Renal dysfunction
Ventricular dysfunction
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