Treatment of Refractory Congestive Heart Failure by Continuous Ambulatory Peritoneal Dialysis

It is usual that patients with congestive heart failure develop intractable heart failure despite restricting water intake, by using diuretics and preload and afterload reducing agents. In the 1960s, we used, as others,(1–6) short-term intermittent peritoneal dialysis (IPD) of hemofiltration (HF) to remove fluid from patients with refractory generalized edema. Such therapies can improve some patients, sometimes even for several months. However, rapid removal of large amounts of fluid is often poorly tolerated in these hemodynamically unstable patients. Continuous ambulatory peritoneal dialysis (CAPD) can combine several advantages — mainly slow and continuous removal of water and sodium. We report here our experiences in using CAPD on a long-term basis in patients with refractory heart failure.