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불응성 심부전증 환자에서 복막투석의 유용성

Other Titles
 Usefulness of Peritoneal Dialysis (PD) in Patients with Refractory Heart Failure (RHF) 
Authors
 유동은  ;  김승준  ;  박선영  ;  오형중  ;  이한성  ;  이정은  ;  최훈영  ;  한승혁  ;  한대석  ;  강신욱 
Citation
 Korean Journal of Nephrology (대한신장학회지), Vol.25(6) : 991-998, 2006 
Journal Title
 Korean Journal of Nephrology (대한신장학회지) 
ISSN
 1225-0015 
Issue Date
2006
Keywords
Heart failure ; Peritoneal dialysis ; Quality of life ; Right ventricular pressure
Abstract
Background: Though PD has served as a treatment method for metabolic derangement in acute or chronic renal failure, it has also been used as a palliative therapy or as a bridge to definite surgery or transplantation in patients with RHF. Some studies have demonstrated that PD reduced hospitalization rates and improved functional capacity in these patients, but changes in echocardiographic findings after PD have not been thoroughly explored. In this study, the effects of PD on hospitalization rates and days, functional status, and echocardiographic parameters were evaluated. Methods: Thirteen patients, in whom PD was performed to treat heart failure, were enrolled. Patients with serum creatinine levels more than 3.0 mg/dL and with acute cardiac event within 1 month before the start of PD were excluded. The clinical, laboratory, and echocardiographic findings before and after the start of PD were compared by carrying out a paired t-test or Wilcoxon signed rank test. Results: Among 13 patients, 11 patients experienced improvement in functional status after the initiation of PD, and the mean NYHA class improved from 3.5±0.5 to 2.3±0.9 after PD treatment (p<0.005). Significant reductions in hospitalization rates (from 1.7±0.4 to 0.2±0.4 episodes/patient-year, p<0.001) and in hospitalization days (from 62.1±26.5 to 3.8±8.9 days/patient-year, p<0.001) were also observed since the start of PD. Echocardiographic findings revealed that right ventricular pressure was significantly reduced in both right-sided and left-sided heart failure patients (p<0.05), whereas there were no significant changes in left ventricular end-diastolic diameter and left ventricular ejection fraction after PD therapy. Conclusion: PD treatment improved quality of life, shortened hospitalization period, and reduced right ventricular pressure in patients with RHF. These findings suggest that PD should be considered as an alternative therapeutic modality for RHF.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Seung Jun(김승준)
Park, Sun Young(박선영)
Oh, Hyung Jung(오형중)
Yoo, Dong Eun(유동은)
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
Lee, Han Sung(이한성)
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
Han, Dae Suk(한대석)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111129
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