腹膜透析治疗难治性充血性心力衰竭的研究进展

Peritoneal Dialysis in Treatment of Refractory Congestive Heart Failure

充血性心力衰竭在世界范围内发病率高、预后差、对生活质量影响大。目前的治疗方法主要包括限制水钠摄入、应用利尿剂、肾素-血管紧张素-醛固酮系统阻滞剂等,但上述方法控制容量作用有限,且常导致有效循环容量下降,肾脏灌注不足,损害肾功能,进而加重循环系统损害。应用腹膜透析治疗难治性充血性心力衰竭能够平稳而有效地改善液体潴留,避免心排血量下降,同时纠正电解质紊乱和肾功能不全。现对腹膜透析治疗难治性充血性心力衰竭的研究进展做一综述。

Worldwide prevalence of congestive heart failure（CHF） remains high. Current treatment of CHF consists of the restriction of salt and fluid, and diuretics and renin-angiotensin-aldosterone system blockers. However, these treatments may result in a drop of effec- tive circulating volume, and insufficient renal perfusion, which in turn trigger aggravated damage to the circulatory system. These treatments also play a limited role in volume control in refractory congestive heart failure（RCHF）. Specifically for RCHF, peritoneal dialysis might be an effective treatment strategy based on the slow but effective uhrafiltration to relieve fluid overload without reducing cardiac output, as well as correction of electrolyte imbalance and protection of renal function. In this review, the development of peritoneal dialysis as a treatment for RCHF is discussed.