Thread by @thekidneykiddo

Thursday mornings at #iqraakidneyclub: Excellent short lecture by Dr Vinugopal on the use of Peritoneal Dialysis in Heart Failure/Cardiorenal Syndromes
Sharing a few slides below:
@hafeeq_benil @drferoz @ranji72 @JyotishGopinat2
#NephTwitter #cardiorenal

How frequent have you started PD for refractory heart failure or CRS type 2?

Starting with the basics -- the classification (which always confuses me btw)
1 & 2 being primarily cardiac, 3 & 4 being primarily renal

1 & 3 being acute, 2 & 4 being chronic

A note on the pathophysiology -- with neurohormonal activation playing the villain here

Common causes of getting a consultation from Cardiology? 👇

So when are you going to recommend starting PD in a patient with heart failure?

Number of hospitalizations is a good clinical assessment tool 👇

Benefits of Peritoneal UF in heart failure? 👇

RAAS inhibitors and Aldosterone antagonists can be used more liberally!!

Potential future approaches?
✨Using a low sodium peritoneal dialysate

✨Using a 'Bimodal' peritoneal dialysate

✨Adapted APD
A good review of these approaches here: karger.com/Article/Pdf/49…

Adapted APD? An interesting concept not used in our part of the world..yet..
Any experiences anyone?

Concluded with discussions that raised questions/points:
✨Difficult to differentiate a CRS type 2 from type 4 in clinical practise, esp when you don't have a solid h/o of renal dysfunction-one can mimic the other
✨Do cardiologists refer the patients to you at the right time?