Galli Emilio Giulio, Taietti Carlo
U.O. di Nefrologia e Dialisi, Dipartimento di Area Medica, Italy.
G Ital Nefrol. 2011 Sep-Oct;28(5):506-13.
Due to its epidemiological characteristics, chronic heart failure refractory to conventional medical treatment is a significant problem involving an increasing number of cardiac patients. Chronic heart failure currently represents one of the most remarkable clinical manifestations of cardiovascular disease because of its frequency, morbidity, impact on quality of life, and costs. The use of new therapeutic approaches is particularly important for patients who become refractory to conventional therapies or are not eligible for heart transplant or other surgical treatment. The benefits of continuous extracorporeal ultrafiltration therapies are well known, but these treatments may be associated with complications and can be used only during hospitalization. Peritoneal ultrafiltration seems to be useful as chronic therapy to improve the quality of life and physical and social rehabilitation of patients with refractory chronic heart failure. The aim of this paper is to evaluate peritoneal ultrafiltration as an integrative treatment in chronic heart failure. Data from the literature suggest that peritoneal ultrafiltration is useful for the preservation of residual renal function, continuous ultrafiltration, hemodynamic stability, better middle-molecule clearance, sodium sieving with maintenance of normonatremia, and reduction of hospital admissions.
由于其流行病学特征，常规药物治疗难以治愈的慢性心力衰竭是一个涉及越来越多心脏病患者的重大问题。慢性心力衰竭目前是心血管疾病最显著的临床表现之一，因其发病率、患病率、对生活质量的影响以及治疗成本。对于那些对常规治疗无效或不符合心脏移植或其他手术治疗条件的患者，采用新的治疗方法尤为重要。连续体外超滤治疗的益处是众所周知的，但这些治疗可能会伴有并发症，且只能在住院期间使用。腹膜超滤似乎作为一种慢性治疗方法，对改善难治性慢性心力衰竭患者的生活质量以及身体和社会康复有益。本文的目的是评估腹膜超滤作为慢性心力衰竭综合治疗方法的效果。文献数据表明，腹膜超滤有助于保留残余肾功能、持续超滤、血流动力学稳定、更好地清除中分子物质、在维持血钠正常的情况下进行钠筛选以及减少住院次数。
