Effects of CRRT on patients with heart failure and diuretic resistance
Liu Xinye, Yang Dongwei, Li Yong, Wang Yanjun
Published 2018-06-10
Cite as Chin J Pract Med, 2018,45(11): 59-61. DOI: 10.3760/cma.j.issn.1674-4756.2018.11.019
Abstract
ObjectiveTo observe the clinical effects of continuous renal replacement therapy (CRRT) on patients with acute exacerbation of chronic heart failure and diuretic resistance.
MethodsOutcome and cardiac function classification (NYHA grading) of 62 patients with acute exacerbation of chronic heart failure and diuretic resistance after CRRT were retrospectively analyzed. The influence of CRRT on atrial natriuretic peptide (BNP) level, heart rate (HR), serum creatinine (Cr) level and left ventricular ejection fraction (LVEF) were analyzed, too. Assessed the risk factors of concurrent diuretic resistance, observed the safety and clinical efficacy of CRRT.
ResultsAfter CRRT treatment, 5 patients died during ultrafiltration treatment, 57 patients reached NYHA Ⅱ to Ⅲ grade, of which 46 cases were cured and discharged, 11 cases were treated by regular hemodialysis, the total effective rate was 91.9%. After treatment, the level of BNP decreased and urinary output increased significantly compared with those before treatment, and the difference was statistically significant (P<0.01); however, there was no significant difference in heart rate and LVEF before and afte treatment (P>0.05). The levels of blood urea nitrogen (BUN), creatinine (Cr) and serum uric acid (UA) were significantly decreased compared with those before treatment, the difference was statistically significant (P<0.01).
ConclusionsDiuretic resistance is more common in patients with chronic heart failure complicated by mild to moderate renal insufficiency and right heart failure. Infection and ischemia are important inducements of worsening heart failure and diuretic resistance, and timely intervention should be given. CRRT is effective and safe for patients with heart failure and diuretic resistance.
Key words:
Severe heart failure; Diuretic resistance; Continuous renal replacement therapy
Contributor Information
Liu Xinye
Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China
Yang Dongwei
Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China
Li Yong
Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China
Wang Yanjun
The Second Military Medical University, Shanghai 200433, China
