Kidney Week

Abstract: FR-PO447

Efficacy and Survival of Patients with Heart Failure on Peritoneal Dialysis as an Ultrafiltration Option: A 10-Year Experience Based on the Catalan Renal Registry

Session Information

• Home Dialysis - 1
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Nunez-Delgado, Sara, Nephrology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain

Sara Nunez-Delgado, MD

• Azancot, María, Nephrology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain

María Azancot, PhD

• León-Román, Juan Carlos, Nephrology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain

Juan Carlos León-Román, MD

• Ramos, Natalia, Nephrology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain

Natalia Ramos, MD, PhD

• Sanchez Escuredo, Ana, Nephrology Department. Hospital Sant Joan Despí - Consorci Sanitari Integral, Sant Joan Despí (Barcelona), Spain

Ana Sanchez Escuredo, MD, PhD

• Soler, Maria Jose, Nephrology Department. Hospital Universitari Vall d'Hebron, Barcelona, Spain

Maria Jose Soler, MD, PhD

Background

In heart failure (HF) disease, approximately 20% of patients will develop diuretic resistance over time. Peritoneal dialysis (PD) could be a therapeutic option, although its long-term outcomes were not reported. Our objective was to analyze the long-term outcomes of PD patients with HF indication (PD-HF).

Methods

Retrospective study of the Catalan Renal Registry of PD-HF patients between 2013-2022. Baseline clinical characteristics and follow-up until December/2022 was described.

Results

Of the 1874 patients starting PD, 198 (10.6 %) were PD-HF, median eGFR at start was 22.6 (IQR 14.8-32.8)ml/min1.73m² and 73.7% have an eGFR above 15 ml/min1.73m². The rest of the baseline characteristics are described in table 1a.
Previous history of ischemic heart disease, arrhythmia or cardiac surgery was recorded, 39% of patients had ≥2 of these pathologies. HF etiology was described in 52.7%, being ischemic heart disease the most prevalent cause (44.4%). Echocardiographic records were available in 19.6% of patients (table 1b).
Median survival was 20 months (IQR 16-24) (figure 1). In the cox multivariate analysis, age >75 years (HR 1.68 [95%CI 1.09-2.60]), frailty (HR 22.64 [95%CI 6.95-73.77]), and past cardiac surgery (HR 1.61 [95%CI 1.08-2.38]) were associated with poor survival (table 1c).
67 patients survived over 24 months. In the logistic regression analysis, age >75 years (OR 4.56 [95%CI 1,60-13,04]) and lower education level (OR 2,41 [95%CI 1,10-5,28]) were associated with higher mortality at 24 months (table 1d).

Conclusion

PD-HF is an appropriate option in patients with heart failure in non-advanced stages. Older age, frailty and lower education levels worsens the prognosis of PD-HF patients.