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      Successful treatment with assisted automated peritoneal dialysis using 4.25% glucose dialysate for an elderly patient with refractory heart failure

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          Abstract

          Refractory heart failure is a major cause of mortality and hospitalization, and peritoneal dialysis (PD) is one of the options for controlling volume overload. Although high glucose dialysate enables a large amount of ultrafiltration, the use of 4.25% glucose dialysate is generally avoided, because high glucose exposure leads to peritoneal damage. Here, we describe a patient who was successfully treated with assisted automated PD using 4.25% glucose dialysate for refractory heart failure. An 84-year-old woman developed heart failure due to severe mitral regurgitation with a low left-ventricular ejection fraction of 30%, and also developed progressive kidney deterioration. She had been refractory to diuretics and repeatedly hospitalized. PD was started to treat refractory heart failure. Since it was difficult for her to change the dialysis bags by herself, assistance with her PD from her family was needed. The use of 4.25% glucose dialysate markedly increased ultrafiltration and improved her condition. In addition, automated PD (APD) using 4.25% glucose dialysate enabled her family to have a break from PD once every 4 days. Thereafter, she had no episodes of hospitalization due to heart failure for approximately 18 months after her discharge.

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          Author and article information

          Contributors
          natoda@kuhp.kyoto-u.ac.jp
          Journal
          CEN Case Rep
          CEN Case Rep
          CEN Case Reports
          Springer Singapore (Singapore )
          2192-4449
          15 September 2020
          February 2021
          : 10
          : 1
          : 121-125
          Affiliations
          [1 ] GRID grid.414973.c, Department of Nephrology, , Kansai Electric Power Hospital, ; 2-1-7, Fukushim, Fukushima-ku 54, Osaka, 553-0003 Japan
          [2 ] GRID grid.416629.e, ISNI 0000 0004 0377 2137, Division of Renal Disease and Blood Purification, , Kansai Electric Power Medical Research Institute, ; Kobe, Japan
          Article
          PMC7829289 PMC7829289 7829289 533
          10.1007/s13730-020-00533-2
          7829289
          32930999
          © Japanese Society of Nephrology 2020
          Categories
          Case Report
          Custom metadata
          © Japanese Society of Nephrology 2021

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