Abstract
AbstractRefractory congestive heart failure (RCHF) is a common complication in the natural history of advanced heart failure. Peritoneal dialysis (PD) is a possible alternative in those patients, but studies are scarce, and mostly with small samples. We conducted this meta-analysis to evaluate the effects of PD in patients with RCHF. Articles published before July 2020 in the following databases: PubMed, Web of Science, and CENTRAL. Mean differences (MD) and 95% confidence intervals (CIs) were computed to generate a pooled effect size with a random effects model. We also assessed heterogeneity, risk of bias, publication bias, and quality of evidence. Twenty observational studies (n = 769) were included, with a “before and after intervention” design. PD was associated with a significant reduction in NYHA functional class (MD −1.37, 95% CI −0.78 to −1.96) and length of hospitalisation (MD −34.8, 95% CI −20.6 to −48.9 days/patient/year), a small but significant increase in left ventricular ejection fraction (MD 4.3, 95%CI 1.9 to 6.8%) and a non-significant change in glomerular filtration rate (MD −3.0, 95% CI −6.0 to 0 mL/min/1.73m2). Heterogeneity among studies was significant and overall risk of bias was rated from moderate to critical. No significant publication bias was found, and the overall quality of evidence was very low for all outcomes. PD in patients with RCHF improved functional class, length of hospitalisation, and ventricular functional, and had no impact in renal function. Further randomised clinical trials are warranted to confirm our results that showed some limitations.
Funder
Centro Hospitalar de Lisboa Central E.P.E.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献