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Volume control in treatment-resistant congestive heart failure: role for peritoneal dialysis

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Abstract

Chronic congestive heart failure (HF) has a rising prevalence and increasing impact on health care systems. Current treatment consists of diuretics, renin–angiotensin–aldosterone system blockers, and restriction of salt and fluids. This strategy is often hampered by a drop in effective circulating volume and hence renal perfusion and function, triggering harmful counter regulatory mechanisms. Slow ultrafiltration by peritoneal dialysis (PD) might be an effective treatment strategy to relieve fluid overload without compromising cardiac output and thereby renal function. In this review, we discuss the (patho)physiological mechanisms of the cardiorenal interaction and the current literature on PD strategies in congestive HF.

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Conflict of interest

Authors Broekman, Sinkeler, Waanders, Bartels, Navis and Janssen have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, Martini Hospital, Van Swietenplein 1, 9700 RM, Groningen, The Netherlands

    K. E. Broekman & W. M. T. Janssen

  2. Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands

    S. J. Sinkeler, F. Waanders & G. Navis

  3. Department of Cardiology, Martini Hospital, Groningen, The Netherlands

    G. L. Bartels

Authors
  1. K. E. Broekman
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  2. S. J. Sinkeler
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  3. F. Waanders
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  4. G. L. Bartels
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  5. G. Navis
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  6. W. M. T. Janssen
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Correspondence to K. E. Broekman.

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Broekman, K.E., Sinkeler, S.J., Waanders, F. et al. Volume control in treatment-resistant congestive heart failure: role for peritoneal dialysis. Heart Fail Rev 19, 709–716 (2014). https://doi.org/10.1007/s10741-014-9421-3

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  • DOI: https://doi.org/10.1007/s10741-014-9421-3

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