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Successful treatment with assisted automated peritoneal dialysis using 4.25% glucose dialysate for an elderly patient with refractory heart failure

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Abstract

Refractory heart failure is a major cause of mortality and hospitalization, and peritoneal dialysis (PD) is one of the options for controlling volume overload. Although high glucose dialysate enables a large amount of ultrafiltration, the use of 4.25% glucose dialysate is generally avoided, because high glucose exposure leads to peritoneal damage. Here, we describe a patient who was successfully treated with assisted automated PD using 4.25% glucose dialysate for refractory heart failure. An 84-year-old woman developed heart failure due to severe mitral regurgitation with a low left-ventricular ejection fraction of 30%, and also developed progressive kidney deterioration. She had been refractory to diuretics and repeatedly hospitalized. PD was started to treat refractory heart failure. Since it was difficult for her to change the dialysis bags by herself, assistance with her PD from her family was needed. The use of 4.25% glucose dialysate markedly increased ultrafiltration and improved her condition. In addition, automated PD (APD) using 4.25% glucose dialysate enabled her family to have a break from PD once every 4 days. Thereafter, she had no episodes of hospitalization due to heart failure for approximately 18 months after her discharge.

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Authors and Affiliations

  1. Department of Nephrology, Kansai Electric Power Hospital, 2-1-7, Fukushim, Fukushima-ku 54, Osaka, 553-0003, Japan

    Naohiro Toda, Ryosuke Iwaki, Kaori Oishi, Yuichi Takasu & Toshiyuki Komiya

  2. Division of Renal Disease and Blood Purification, Kansai Electric Power Medical Research Institute, Kobe, Japan

    Naohiro Toda & Toshiyuki Komiya

Authors
  1. Naohiro Toda
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  2. Ryosuke Iwaki
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  3. Kaori Oishi
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  4. Yuichi Takasu
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  5. Toshiyuki Komiya
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Correspondence to Naohiro Toda.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Toda, N., Iwaki, R., Oishi, K. et al. Successful treatment with assisted automated peritoneal dialysis using 4.25% glucose dialysate for an elderly patient with refractory heart failure. CEN Case Rep 10, 121–125 (2021). https://doi.org/10.1007/s13730-020-00533-2

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  • DOI: https://doi.org/10.1007/s13730-020-00533-2

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