Introduction: The aim of the study was to demonstrate the outcomes of peritoneal dialysis (PD) in critically ill cardiorenal syndrome type 1 (CRS1). Methods: A cohort of 147 patients with CRS1 who received PD from 2011 to 2019 in a referral hospital in Thailand was analyzed. The primary outcome was 30-day in-hospital mortality. Ultrafiltration and net fluid balance among survivors and nonsurvivors in the first 5 PD sessions were compared. Results: The 30-day mortality rate was 73.4%. Most patients were critically ill CRS1 (all patients had a respiratory failure of which 68% had cardiogenic shock). Blood urea nitrogen and creatinine at the commencement of PD were 60.1 and 4.05 mg/dL. In multivariable analysis, increasing age, unstable hemodynamics, and positive fluid balance in the first 5 PD sessions were associated with the risk of in-hospital mortality. The change of fluid balance per day during the first 5 dialysis days was significantly different among survivor and nonsurvivor groups (−353 vs. 175 mL per day, p = 0.01). Conclusions: PD is a viable dialysis option in CRS1, especially in a resource-limited setting. PD can save up to 27% of lives among patients with critically ill CRS1.
Cardiorenal Med

中文翻译：

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危重心肾综合征 1 型急性腹膜透析后的结果

简介：该研究的目的是证明腹膜透析 (PD) 在危重心肾综合征 1 型 (CRS1) 中的结果。方法：分析了 2011 年至 2019 年在泰国转诊医院接受 PD 治疗的 147 名 CRS1 患者队列。主要结果是 30 天住院死亡率。对前 5 次 PD 治疗中幸存者和非幸存者的超滤和净体液平衡进行了比较。结果：30天死亡率为73.4%。大多数患者为重症 CRS1（所有患者均出现呼吸衰竭，其中 68% 为心源性休克）。PD 开始时的血尿素氮和肌酐分别为 60.1 和 4.05 mg/dL。在多变量分析中，前 5 次 PD 治疗中年龄增加、血流动力学不稳定和液体正平衡与院内死亡风险相关。存活组和非存活组的前 5 天透析期间每天的体液平衡变化显着不同（-353 对 175 毫升/天，p = 0.01）。结论： PD 是 CRS1 中可行的透析选择，尤其是在资源有限的情况下。在危重 CRS1 患者中，PD 可以挽救多达 27% 的生命。
心肾医学