Scompenso cardiaco resistente ai farmaci: Approccio nefrologico

Translated title of the contribution: Heart failure refractory to medical therapy. Nephrological approach

E. Ragazzoni, A. Sacco, S. Cusinato, S. Agliata, K. Schweiger, A. Cavagnino, M. Zanetta, V. Cardillo, U. Corrà

Research output: Contribution to journalArticle

Abstract

Background. The congestive heart failure (IV cl. NYHA) refractory to medical therapy, can be treated with ultrafiltrative method such as extracorporeal ultrafiltration (UP), intermittent veno-venosus hemofiltration, intermittent peritoneal dialysis (EPD) or chronic ambulatory peritoneal dialysis (CAPD). Methods. Sixty-one patients suffering from SCC have been managed by combining medical therapy with ultrafiltrative treatment. Results. 28% (17 patients) died within a week from ultrafiltrative therapy beginning. 39% (24 patients) took up to respond to medical therapy (responders). 33% (20 patients) didn't give a proper response to pharmacological therapy (non responders), therefore a ultrafiltration program with chronic ambulatory peritoneal dialysis (CAPD) has been undertaken. Among ultrafiltrative methods applied to patients, IVVH is the most effective. Clinical parameters analysis, relevant to dehydration acute phase, points out: - an evident loss of corporeal weight between dehydration pre-post phases in all 3 groups, with statistically significant results; - a SAP values reduction between the beginning and the end of treatment in all 3 groups; - a PAD values reduction in the group of deceased and non responders. This value remains stable in responders group. Non responders patients, inserted in a ultrafiltration program with CAPD present the following survival rate: - 55%: 6 months; - 35%: 1 year; - 15%: 4 years. These patients maintain a good self-management in 50%, sufficient in 35% and totally partner-dependent in 15%. Conclusions. Ultrafiltration method together with pharmacological therapy allows a resetting of neuro-endocrine and electrolytic system in refractory congestive heart failure patients and a recovery of a pharmacological response. Without such a response a cardio-circulatory balance can be maintained through a CAPD method.

Original languageItalian
Pages (from-to)133-138
Number of pages6
JournalMinerva Urologica e Nefrologica
Volume50
Issue number2
Publication statusPublished - 1998

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Heart Failure
Peritoneal Dialysis
Ultrafiltration
Pharmacology
Therapeutics
Dehydration
Hemofiltration
Endocrine System
Self Care
Weight Loss
Survival Rate

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Ragazzoni, E., Sacco, A., Cusinato, S., Agliata, S., Schweiger, K., Cavagnino, A., ... Corrà, U. (1998). Scompenso cardiaco resistente ai farmaci: Approccio nefrologico. Minerva Urologica e Nefrologica, 50(2), 133-138.

Scompenso cardiaco resistente ai farmaci : Approccio nefrologico. / Ragazzoni, E.; Sacco, A.; Cusinato, S.; Agliata, S.; Schweiger, K.; Cavagnino, A.; Zanetta, M.; Cardillo, V.; Corrà, U.

In: Minerva Urologica e Nefrologica, Vol. 50, No. 2, 1998, p. 133-138.

Research output: Contribution to journalArticle

Ragazzoni, E, Sacco, A, Cusinato, S, Agliata, S, Schweiger, K, Cavagnino, A, Zanetta, M, Cardillo, V & Corrà, U 1998, 'Scompenso cardiaco resistente ai farmaci: Approccio nefrologico', Minerva Urologica e Nefrologica, vol. 50, no. 2, pp. 133-138.
Ragazzoni E, Sacco A, Cusinato S, Agliata S, Schweiger K, Cavagnino A et al. Scompenso cardiaco resistente ai farmaci: Approccio nefrologico. Minerva Urologica e Nefrologica. 1998;50(2):133-138.
Ragazzoni, E. ; Sacco, A. ; Cusinato, S. ; Agliata, S. ; Schweiger, K. ; Cavagnino, A. ; Zanetta, M. ; Cardillo, V. ; Corrà, U. / Scompenso cardiaco resistente ai farmaci : Approccio nefrologico. In: Minerva Urologica e Nefrologica. 1998 ; Vol. 50, No. 2. pp. 133-138.
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abstract = "Background. The congestive heart failure (IV cl. NYHA) refractory to medical therapy, can be treated with ultrafiltrative method such as extracorporeal ultrafiltration (UP), intermittent veno-venosus hemofiltration, intermittent peritoneal dialysis (EPD) or chronic ambulatory peritoneal dialysis (CAPD). Methods. Sixty-one patients suffering from SCC have been managed by combining medical therapy with ultrafiltrative treatment. Results. 28{\%} (17 patients) died within a week from ultrafiltrative therapy beginning. 39{\%} (24 patients) took up to respond to medical therapy (responders). 33{\%} (20 patients) didn't give a proper response to pharmacological therapy (non responders), therefore a ultrafiltration program with chronic ambulatory peritoneal dialysis (CAPD) has been undertaken. Among ultrafiltrative methods applied to patients, IVVH is the most effective. Clinical parameters analysis, relevant to dehydration acute phase, points out: - an evident loss of corporeal weight between dehydration pre-post phases in all 3 groups, with statistically significant results; - a SAP values reduction between the beginning and the end of treatment in all 3 groups; - a PAD values reduction in the group of deceased and non responders. This value remains stable in responders group. Non responders patients, inserted in a ultrafiltration program with CAPD present the following survival rate: - 55{\%}: 6 months; - 35{\%}: 1 year; - 15{\%}: 4 years. These patients maintain a good self-management in 50{\%}, sufficient in 35{\%} and totally partner-dependent in 15{\%}. Conclusions. Ultrafiltration method together with pharmacological therapy allows a resetting of neuro-endocrine and electrolytic system in refractory congestive heart failure patients and a recovery of a pharmacological response. Without such a response a cardio-circulatory balance can be maintained through a CAPD method.",
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T1 - Scompenso cardiaco resistente ai farmaci

T2 - Approccio nefrologico

AU - Ragazzoni, E.

AU - Sacco, A.

AU - Cusinato, S.

AU - Agliata, S.

AU - Schweiger, K.

AU - Cavagnino, A.

AU - Zanetta, M.

AU - Cardillo, V.

AU - Corrà, U.

PY - 1998

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N2 - Background. The congestive heart failure (IV cl. NYHA) refractory to medical therapy, can be treated with ultrafiltrative method such as extracorporeal ultrafiltration (UP), intermittent veno-venosus hemofiltration, intermittent peritoneal dialysis (EPD) or chronic ambulatory peritoneal dialysis (CAPD). Methods. Sixty-one patients suffering from SCC have been managed by combining medical therapy with ultrafiltrative treatment. Results. 28% (17 patients) died within a week from ultrafiltrative therapy beginning. 39% (24 patients) took up to respond to medical therapy (responders). 33% (20 patients) didn't give a proper response to pharmacological therapy (non responders), therefore a ultrafiltration program with chronic ambulatory peritoneal dialysis (CAPD) has been undertaken. Among ultrafiltrative methods applied to patients, IVVH is the most effective. Clinical parameters analysis, relevant to dehydration acute phase, points out: - an evident loss of corporeal weight between dehydration pre-post phases in all 3 groups, with statistically significant results; - a SAP values reduction between the beginning and the end of treatment in all 3 groups; - a PAD values reduction in the group of deceased and non responders. This value remains stable in responders group. Non responders patients, inserted in a ultrafiltration program with CAPD present the following survival rate: - 55%: 6 months; - 35%: 1 year; - 15%: 4 years. These patients maintain a good self-management in 50%, sufficient in 35% and totally partner-dependent in 15%. Conclusions. Ultrafiltration method together with pharmacological therapy allows a resetting of neuro-endocrine and electrolytic system in refractory congestive heart failure patients and a recovery of a pharmacological response. Without such a response a cardio-circulatory balance can be maintained through a CAPD method.

AB - Background. The congestive heart failure (IV cl. NYHA) refractory to medical therapy, can be treated with ultrafiltrative method such as extracorporeal ultrafiltration (UP), intermittent veno-venosus hemofiltration, intermittent peritoneal dialysis (EPD) or chronic ambulatory peritoneal dialysis (CAPD). Methods. Sixty-one patients suffering from SCC have been managed by combining medical therapy with ultrafiltrative treatment. Results. 28% (17 patients) died within a week from ultrafiltrative therapy beginning. 39% (24 patients) took up to respond to medical therapy (responders). 33% (20 patients) didn't give a proper response to pharmacological therapy (non responders), therefore a ultrafiltration program with chronic ambulatory peritoneal dialysis (CAPD) has been undertaken. Among ultrafiltrative methods applied to patients, IVVH is the most effective. Clinical parameters analysis, relevant to dehydration acute phase, points out: - an evident loss of corporeal weight between dehydration pre-post phases in all 3 groups, with statistically significant results; - a SAP values reduction between the beginning and the end of treatment in all 3 groups; - a PAD values reduction in the group of deceased and non responders. This value remains stable in responders group. Non responders patients, inserted in a ultrafiltration program with CAPD present the following survival rate: - 55%: 6 months; - 35%: 1 year; - 15%: 4 years. These patients maintain a good self-management in 50%, sufficient in 35% and totally partner-dependent in 15%. Conclusions. Ultrafiltration method together with pharmacological therapy allows a resetting of neuro-endocrine and electrolytic system in refractory congestive heart failure patients and a recovery of a pharmacological response. Without such a response a cardio-circulatory balance can be maintained through a CAPD method.

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KW - Heart failure, congestive

KW - Hemofiltration, methods

KW - Peritoneal dialysis

KW - Peritoneal dialysis, continuous ambulatory

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