Uso da diálise peritoneal em pacientes com insuficiência cardíaca congestiva Use of peritoneal dialysis on patients with congestive heart failure

RESUMO Teoricamente, a dialise peritoneal parece ser superior a hemodialise na regulacao de volume no contexto da insufici encia cardiaca congestiva em virtude da ultrafiltracao conti nua e do menor numero de consequencias hemodinâmicas. Existem varias series na literatura, apesar de conterem um numero pequeno de casos, evidenciando o uso bem-sucedido da dialise peritoneal no manejo da sobrecarga de volume que ocorre no paciente com insuficiencia cardiaca refrataria com melhora na qualidade de vida, reducao na morbidade e no numero de hospitalizacoes. Mas, num grande estudo observacional, pacientes com doenca renal cronica terminal que iniciaram programa de dialise, com algum grau de insuficiencia cardiaca congestiva, tiveram melhores resultados em hemodialise do que em dialise peritoneal. Um estudo prospectivo randomizado e necessario para esclarecer o impacto da modalidade de dialise na sobrevida de pacientes com insuficiencia cardiaca congestiva. PALAVRAS-CHAVE Insuficiencia cardiaca congestiva, dialise peritoneal, hemodialise.

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