Clinical Significance of Renal Hemodynamics in Severe Congestive Heart Failure: Responsiveness to Ultrafiltration Therapies : SYMPOSIUM ON PATHOPHYSIOLOGY AND SEVERITY OF HEART FAILURE IN THE ASPECT OF CIRCULATORY INSUFFICIENCY

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Isolated ultrafiltration, hemodialysis & peritoneal dialysis (Tx) were recently used in the treatment of intractable heart failure (HF). We examined the relation between the response of HF to Tx and the residual kidney functions. Tx was carried out in 17 patients (Pts) with HF who did not respond to aggressive medical treatment. Ten Pts (R) responded to Tx and 7 Pts 8N) did not. Serum urea nitrogen (UN), creatinine (Cr), uric acid (UA9, sodium (Na),, potassium (K9, and chloride (Cl) concentrations on admission and before Tx were not different between R and N. Urine UN, Cr, Na, K and Cl on admission and before Tx were also not significantly different. Fractional sodium excretions (FENa), renal failure indices (RFI), and urine/plasma Cr rations 8U/P Cr) on admission were 2.0 ± 1.6, 2.7 ± 2.2, and 30.5 ±20.0 in R and 5.9 ± 4.2, 8.2 ± 6.0 and 11.5 ± 3.8 in N. They were significantly different (p<0.05). However, these did not differ before and after Tx. These data show that FENa, RFI and U/P Cr might be useful indices in predicting the responsiveness of intractable HF to Tx.
社団法人日本循環器学会の論文
1989-02-20