Can we treat fluid overload with fluid? Role of peritoneal dialysis in management of heart failure

Fluid overload contributing to heart failure.

BACKGROUND In advanced heart failure, the compensatory responses to reduced cardiac output, in spite of fluid retention, lead to maladaptive consequences. METHODS We performed a Medline survey for fluid overload and heart failure as well as reviewing textbook chapters. RESULTS The increased sympathetic nervous system, renin-angiotensin-aldosterone system, and antidiuretic hormone stimulatio...

Fluid Volume Overload and Congestion in Heart Failure

Abstract—Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid c...

Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. ...

Hazard of peritoneal dialysis: contaminated fluid.

Icodextrin as salvage therapy in peritoneal dialysis patients with refractory fluid overload

BACKGROUND Icodextrin is a high molecular weight, starch-derived glucose polymer, which is capable of inducing sustained ultrafiltration over prolonged (12-16 hour) peritoneal dialysis (PD) dwells. The aim of this study was to evaluate the ability of icodextrin to alleviate refractory, symptomatic fluid overload and prolong technique survival in PD patients. METHODS A prospective, open-label,...