13 research outputs found
Dialytic treatment in patients with renal insufficiency and heart failure refractory to combined drug therapy
OBJECTIVE
The incidence and prevalence of heart failure are continuously on the increase. Pharmacological therapy is not sufficient in the advanced stages of the illness to control the signs and symptoms, especially when stressing factors intervene and complicate the illness course. Dialytic treatments are always indicated more than necessary in the severe forms of heart failure, but the optimal treatment has not yet been established.
METHOD
In our division, 24 patients with heart failure (III-IV NYHA) and renal failure (III-IV NKF-DOQI) were treated with low flux bicarbonate dialysis, variable dialysate and limited ultra-filtration.
RESULT
Arrhythmia, pericarditis, ischemic cardiopathy and hyponatremia were the stressing factors that determined acute heart failure. Fifteen patients presented with diastolic failure, whereas nine patients had systolic heart failure. The first group of patients had higher arterial pressure, better ejection fraction and better prognosis regarding renal function and survival rate. The results obtained with this treatment in prevalently diastolic heart failure are satisfactory in terms of survival, as well as in renal function recovery, whereas they are not adequate in systolic failure where other approaches are being studied.
CONCLUSION
Therefore, we believe that the therapeutic choice must always be determined in relation to the type of heart failure
Temporary dialysis treatments for heart failure in chronic kidney disease.
OBJECTIVE
Patients with cardiac disease and chronic kidney disease are admitted to our emergency unit with signs and symptoms of severe heart failure more and more frequently.
METHOD
Resistance to high-dose loop diuretics imposes the use of renal replacement therapy.
RESULT
We treated a group of these patients with personalized bicarbonate dialysis, deciding the number and frequency of treatment sessions according to the patient's clinical conditions. Heart failure can be classified as mainly diastolic or systolic. Results show that bicarbonate dialysis is effective and well tolerated, primarily in the treatment of patients with prevalently diastolic heart failure.
CONCLUSION
Patients with prevalently systolic heart failure have a worse prognosis
[Effectiveness of daptomycin in the treatment of patients on hemodialysis affected by CVC infection]
Quality of life in patients with combined treatments for heart failure
The low quality of life in patients with end-stage heart failure is correlated, above all, to frequent hospitalization and to the awareness of having an illness that limits survival. The quality of life in these patients with heart failure using treatment with sustained low efficiency dialysis (SLED) is determined through the Minnesota Living with Heart Failure (MLHF) Questionnaire. The reliability of this evaluation system has been examined through consultation with international trials. After 1 yr of this treatment, we observed an improvement in quality of lif