腹膜透析治疗难治性心力衰竭的研究现状

Peritoneal dialysis for refractory heart failure

慢性心力衰竭是临床常见的心血管疾病,难治性心力衰竭(RHF)是心功能不全的终末阶段。药物治疗RHF存在诸多问题,如肾功能恶化、电解质及内环境紊乱、利尿剂抵抗等。降低钠潴留是RHF重要治疗目标之一。腹膜透析(PD)可有效降低RHF患者钠水潴留、提高心脏射血分数、改善心力衰竭症状、减少住院次数、缩短住院时间。本文综述PD在RHF的合理应用及研究现状,包括适应证、干预时机、剂量与透析模式、联合用药及未来发展方向等。

Chronic heart failure is a common clinical cardiovascular disease and refractory heart failure(RHF)is the final stage of cardiac insuffciency.Renal sodium retention remains a key event in the pathogenesis of the disease progression and episodes of severe cardiac decompensation.Peritoneal dialysis(PD)is a home-based therapeutic modality then can be used in patients with RHF.Studies of PD in heart failure patients with chronic kidney disease and refractory fluid overload have shown this modality is associated with weight loss,improved quality of life,and reduction in heart failure hospitalizations and increase in left ventricular ejection fraction(LVEF).We aim to review the contemporary evidence of PD in patients with RHF across the spectrum of indications,optimal timing of PD intervention,techniques,and vasoactive medicine therapy.