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Customization of Peritoneal Dialysis in Cardiorenal Syndrome by Optimization of Sodium Extraction
- Source :
- Cardiorenal Medicine. 9:117-124
- Publication Year :
- 2019
- Publisher :
- S. Karger AG, 2019.
-
Abstract
- Background: Peritoneal dialysis (PD) has emerged as a mechanistically relevant therapeutic option for patients with heart failure (HF), volume overload, and varying degrees of renal dysfunction (i.e., chronic cardiorenal syndrome). Congestion has been identified as a potent ominous prognostic factor in this patient population, outperforming a number of established risk factors. As such, excess fluid removal is recognized as a relevant therapeutic target in this setting. Methods: Accumulating evidence points to the importance of sodium removal as part of any decongestive strategy because extraction of sodium-free water has little or no impact on the outcomes of these patients. Hence, optimization of sodium removal by PD should be the primary focus in the setting of HF and cardiorenal syndrome, especially if PD is started when the patient still has adequate residual renal function for clearance of waste products. Results: Herein, we provide an overview of approaches that can tailor PD treatment to the patients’ characteristics and clinical needs (e.g., choice of PD modality) to fully exploit its decongestive properties. Other methods that could prove helpful in the future will also be briefly discussed. Conclusion: While these strategies could help with efficient sodium extraction and volume optimization, future studies are needed to evaluate their impact on the outcomes of this specific patient population.
- Subjects :
- Prognostic factor
medicine.medical_specialty
Future studies
Urology
medicine.medical_treatment
030232 urology & nephrology
Volume overload
Renal function
Cardiorenal syndrome
030204 cardiovascular system & hematology
Peritoneal dialysis
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine
Humans
Intensive care medicine
Heart Failure
Cardio-Renal Syndrome
business.industry
Sodium
medicine.disease
Patient population
Treatment Outcome
Heart failure
Cardiology and Cardiovascular Medicine
business
Peritoneal Dialysis
Subjects
Details
- ISSN :
- 16645502 and 16643828
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Cardiorenal Medicine
- Accession number :
- edsair.doi.dedup.....0232f58502ac461ca4dc405291074440