Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients
Abstract Background Peritoneal ultrafiltration (pUF) in refractory heart failure (HF) reduces the incidence of decompensation episodes, which is of particular significance as each episode incrementally adds to mortality. Nevertheless, there are insufficient data about which patient cohort benefits t...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-020-01777-x |
| _version_ | 1818034248181874688 |
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| author | Leonie Grossekettler Bastian Schmack Carsten Brockmann Reinhard Wanninger Michael M. Kreusser Lutz Frankenstein Lars P. Kihm Martin Zeier Hugo A. Katus Vedat Schwenger Andrew Remppis |
| author_facet | Leonie Grossekettler Bastian Schmack Carsten Brockmann Reinhard Wanninger Michael M. Kreusser Lutz Frankenstein Lars P. Kihm Martin Zeier Hugo A. Katus Vedat Schwenger Andrew Remppis |
| author_sort | Leonie Grossekettler |
| collection | DOAJ |
| description | Abstract Background Peritoneal ultrafiltration (pUF) in refractory heart failure (HF) reduces the incidence of decompensation episodes, which is of particular significance as each episode incrementally adds to mortality. Nevertheless, there are insufficient data about which patient cohort benefits the most. The objective of this study was to compare pUF in HFrEF and HFpEF, focusing on functional status, hospitalizations, surrogate endpoints and mortality. Methods This study involves 143 patients, who could be classified as either HFpEF (n = 37, 25.9%) or HFrEF (n = 106, 74.1%) and who received pUF due to refractory HF. Results Baseline eGFR was similar in HFrEF (23.1 ± 10.6 mg/dl) and HFpEF (27.8 ± 13.2 mg/dl). Significant improvements in NYHA class were found in HFpEF (3.19 ± 0.61 to 2.72 ± 0.58, P < 0.001) and HFrEF (3.45 ± 0.52 to 2.71 ± 0.72, P < 0.001). CRP decreased in HFrEF (19.4 ± 17.6 mg/l to 13.7 ± 21.4 mg/l, P = 0.018) and HFpEF (33.7 ± 52.6 mg/l to 17.1 ± 26.3 mg/l, P = 0.004). Body weight was significantly reduced in HFrEF (81.1 ± 14.6 kg to 77.2 ± 15.6 kg, P = 0.003) and HFpEF (86.9 ± 15.8 kg to 83.1 ± 15.9 kg, P = 0.005). LVEF improved only in HFrEF (25.9 ± 6.82% to 30.4 ± 12.2%, P = 0.046). BCR decreased significantly in HFrEF and HFpEF (55.7 ± 21.9 to 34.3 ± 17.9 P > 0.001 and 50.5 ± 68.9 to 37.6 ± 21.9, P = 0.006). Number of hospitalization episodes as well as number of hospitalization days decreased significantly only in HFpEF (total number 2.88 ± 1.62 to 1.25 ± 1.45, P < 0.001, days 40.4 ± 31.7 to 18.3 ± 22.5 days, P = 0.005). Conclusions pUF offers various benefits in HFpEF and HFrEF, but there are also substantial differences. In particular, hospitalization rates were found to be significantly reduced in HFpEF patients, indicating a greater medical and economical advantage. However, LVEF was only found to be improved in HFrEF patients. While pUF can now be regarded as an option to supplement classical HF therapy, further studies are desirable to obtain specifications about pUF in HFpEF, HFmEF and HFrEF patients. |
| first_indexed | 2024-12-10T06:36:08Z |
| format | Article |
| id | doaj.art-1c5a5311d3744e27b6680a4e6ea9ac66 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-10T06:36:08Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-1c5a5311d3744e27b6680a4e6ea9ac662022-12-22T01:58:56ZengBMCBMC Nephrology1471-23692020-05-0121111210.1186/s12882-020-01777-xBenefits of peritoneal ultrafiltration in HFpEF and HFrEF patientsLeonie Grossekettler0Bastian Schmack1Carsten Brockmann2Reinhard Wanninger3Michael M. Kreusser4Lutz Frankenstein5Lars P. Kihm6Martin Zeier7Hugo A. Katus8Vedat Schwenger9Andrew Remppis10Department of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of HeidelbergClinic for Cardiac Surgery, University Hospital of HeidelbergClinic for Cardiology, Heart and Vascular CenterDepartment of Nephrology, Medical CenterDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of HeidelbergDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of HeidelbergDepartment of Nephrology, Clinic BraunschweigDepartment of Nephrology, Clinic BraunschweigDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of HeidelbergDepartment of Nephrology, Clinic BraunschweigDepartment of Kidney-, Blood Pressure- and Autoimmune Diseases, Katharinenhospital, Klinikum StuttgartAbstract Background Peritoneal ultrafiltration (pUF) in refractory heart failure (HF) reduces the incidence of decompensation episodes, which is of particular significance as each episode incrementally adds to mortality. Nevertheless, there are insufficient data about which patient cohort benefits the most. The objective of this study was to compare pUF in HFrEF and HFpEF, focusing on functional status, hospitalizations, surrogate endpoints and mortality. Methods This study involves 143 patients, who could be classified as either HFpEF (n = 37, 25.9%) or HFrEF (n = 106, 74.1%) and who received pUF due to refractory HF. Results Baseline eGFR was similar in HFrEF (23.1 ± 10.6 mg/dl) and HFpEF (27.8 ± 13.2 mg/dl). Significant improvements in NYHA class were found in HFpEF (3.19 ± 0.61 to 2.72 ± 0.58, P < 0.001) and HFrEF (3.45 ± 0.52 to 2.71 ± 0.72, P < 0.001). CRP decreased in HFrEF (19.4 ± 17.6 mg/l to 13.7 ± 21.4 mg/l, P = 0.018) and HFpEF (33.7 ± 52.6 mg/l to 17.1 ± 26.3 mg/l, P = 0.004). Body weight was significantly reduced in HFrEF (81.1 ± 14.6 kg to 77.2 ± 15.6 kg, P = 0.003) and HFpEF (86.9 ± 15.8 kg to 83.1 ± 15.9 kg, P = 0.005). LVEF improved only in HFrEF (25.9 ± 6.82% to 30.4 ± 12.2%, P = 0.046). BCR decreased significantly in HFrEF and HFpEF (55.7 ± 21.9 to 34.3 ± 17.9 P > 0.001 and 50.5 ± 68.9 to 37.6 ± 21.9, P = 0.006). Number of hospitalization episodes as well as number of hospitalization days decreased significantly only in HFpEF (total number 2.88 ± 1.62 to 1.25 ± 1.45, P < 0.001, days 40.4 ± 31.7 to 18.3 ± 22.5 days, P = 0.005). Conclusions pUF offers various benefits in HFpEF and HFrEF, but there are also substantial differences. In particular, hospitalization rates were found to be significantly reduced in HFpEF patients, indicating a greater medical and economical advantage. However, LVEF was only found to be improved in HFrEF patients. While pUF can now be regarded as an option to supplement classical HF therapy, further studies are desirable to obtain specifications about pUF in HFpEF, HFmEF and HFrEF patients.http://link.springer.com/article/10.1186/s12882-020-01777-xHeart failureHFpEFHFrEFCardiorenal syndromePeritoneal dialysisUltrafiltration |
| spellingShingle | Leonie Grossekettler Bastian Schmack Carsten Brockmann Reinhard Wanninger Michael M. Kreusser Lutz Frankenstein Lars P. Kihm Martin Zeier Hugo A. Katus Vedat Schwenger Andrew Remppis Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients BMC Nephrology Heart failure HFpEF HFrEF Cardiorenal syndrome Peritoneal dialysis Ultrafiltration |
| title | Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients |
| title_full | Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients |
| title_fullStr | Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients |
| title_full_unstemmed | Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients |
| title_short | Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients |
| title_sort | benefits of peritoneal ultrafiltration in hfpef and hfref patients |
| topic | Heart failure HFpEF HFrEF Cardiorenal syndrome Peritoneal dialysis Ultrafiltration |
| url | http://link.springer.com/article/10.1186/s12882-020-01777-x |
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