Successful Peritoneal Dialysis for the Treatment of Inotrope-Dependent End-Stage Heart Failure

Int Heart J. 2019 Sep 27;60(5):1211-1218. doi: 10.1536/ihj.18-550. Epub 2019 Sep 4.

Abstract

Extra- and/or intracorporeal renal replacement therapy can improve the cardiorenal hemodynamics in patients with advanced heart failure (HF) refractory to medical therapy and renal failure. Here, we report the case of a 51-year-old woman with inotrope-dependent end-stage HF and chronic renal failure due to anthracycline-induced cardiomyopathy, in whom the induction of hemodiafiltration and subsequent chronic peritoneal dialysis (PD) provided a dramatic improvement of her cardiac hemodynamics from restrictive to almost normal physiology assessed by echocardiography and cardiac catheterization. The patient returned to office work with New York Heart Association functional class I-II symptoms for at least 3 years with continuous ambulatory PD after hospital discharge.

Keywords: Cardiac hemodynamics; Renal failure.

Publication types

  • Case Reports

MeSH terms

  • Anthracyclines / adverse effects
  • Anthracyclines / therapeutic use
  • Biopsy, Needle
  • Cardio-Renal Syndrome / diagnostic imaging
  • Cardio-Renal Syndrome / therapy*
  • Chronic Disease
  • Disease Progression
  • Echocardiography, Doppler / methods
  • Electrocardiography / methods
  • Female
  • Heart Failure / complications*
  • Heart Failure / diagnostic imaging*
  • Heart Failure / therapy
  • Hemodiafiltration / methods
  • Hemodynamics / physiology
  • Humans
  • Immunohistochemistry
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / therapy*
  • Middle Aged
  • Peritoneal Dialysis / methods*
  • Prognosis
  • Return to Work
  • Treatment Outcome

Substances

  • Anthracyclines