Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema?
Background Managing acute coronary syndrome (ACS) with pulmonary edema is challenging in end-stage kidney disease (ESKD) patients on dialysis. While hemodialysis (HD) is often chosen for rapid fluid removal, peritoneal dialysis (PD) may better preserve hemodynamic stability in patients prone to circ...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2534502 |
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| author | Yahn-Bor Chern Yu-Ling Lin Hsi-Hao Wang Shih-Yuan Hung Min-Yu Chang Li-Chun Ho Ching-Fang Wu Hung-Hsiang Liou Yi-Che Lee |
| author_facet | Yahn-Bor Chern Yu-Ling Lin Hsi-Hao Wang Shih-Yuan Hung Min-Yu Chang Li-Chun Ho Ching-Fang Wu Hung-Hsiang Liou Yi-Che Lee |
| author_sort | Yahn-Bor Chern |
| collection | DOAJ |
| description | Background Managing acute coronary syndrome (ACS) with pulmonary edema is challenging in end-stage kidney disease (ESKD) patients on dialysis. While hemodialysis (HD) is often chosen for rapid fluid removal, peritoneal dialysis (PD) may better preserve hemodynamic stability in patients prone to circulatory compromise. This study evaluated whether continuing PD in patients who develop ACS and pulmonary edema while already on PD is feasible for improving oxygenation and fluid management without switching to HD.Methods This retrospective single-center study reviewed 13 PD patients who experienced 15 ACS episodes complicated by pulmonary edema. Data collected included demographics, comorbidities, Killip classification, PD regimen modifications, and outcomes. Adjustments to PD prescriptions and their effectiveness were assessed.Results Among the 15 episodes, 11 (73.3%) were successfully managed with PD alone, while 4 (26.7%) required temporary HD due to insufficient fluid removal. Most cases were Killip Class II (20%) or III (73.3%). The average ICU stay was 4 days, and in-hospital mortality was 20%.Conclusions Continuation of PD in patients who develop ACS accompanied by pulmonary edema appears feasible in most cases, provided that PD prescriptions are carefully individualized. Switching to HD is not invariably required, but thoughtful patient selection and close monitoring remain essential to optimize clinical outcomes. |
| format | Article |
| id | doaj-art-62decf5221504e65964c141feca4d9c2 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-62decf5221504e65964c141feca4d9c22025-08-20T03:31:53ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2534502Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema?Yahn-Bor Chern0Yu-Ling Lin1Hsi-Hao Wang2Shih-Yuan Hung3Min-Yu Chang4Li-Chun Ho5Ching-Fang Wu6Hung-Hsiang Liou7Yi-Che Lee8Division of Nephrology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Hsinchu Cathay General Hospital, Hsinchu, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Nephrology, Department of Internal Medicine, Hsin-Jen Hospital, New Taipei City, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanBackground Managing acute coronary syndrome (ACS) with pulmonary edema is challenging in end-stage kidney disease (ESKD) patients on dialysis. While hemodialysis (HD) is often chosen for rapid fluid removal, peritoneal dialysis (PD) may better preserve hemodynamic stability in patients prone to circulatory compromise. This study evaluated whether continuing PD in patients who develop ACS and pulmonary edema while already on PD is feasible for improving oxygenation and fluid management without switching to HD.Methods This retrospective single-center study reviewed 13 PD patients who experienced 15 ACS episodes complicated by pulmonary edema. Data collected included demographics, comorbidities, Killip classification, PD regimen modifications, and outcomes. Adjustments to PD prescriptions and their effectiveness were assessed.Results Among the 15 episodes, 11 (73.3%) were successfully managed with PD alone, while 4 (26.7%) required temporary HD due to insufficient fluid removal. Most cases were Killip Class II (20%) or III (73.3%). The average ICU stay was 4 days, and in-hospital mortality was 20%.Conclusions Continuation of PD in patients who develop ACS accompanied by pulmonary edema appears feasible in most cases, provided that PD prescriptions are carefully individualized. Switching to HD is not invariably required, but thoughtful patient selection and close monitoring remain essential to optimize clinical outcomes.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2534502Acute coronary syndromechronic kidney diseasehemodialysisend-stage kidney diseaseperitoneal dialysispulmonary edema |
| spellingShingle | Yahn-Bor Chern Yu-Ling Lin Hsi-Hao Wang Shih-Yuan Hung Min-Yu Chang Li-Chun Ho Ching-Fang Wu Hung-Hsiang Liou Yi-Che Lee Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? Renal Failure Acute coronary syndrome chronic kidney disease hemodialysis end-stage kidney disease peritoneal dialysis pulmonary edema |
| title | Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? |
| title_full | Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? |
| title_fullStr | Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? |
| title_full_unstemmed | Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? |
| title_short | Can peritoneal dialysis be continued, as opposed to switching to HD, in end-stage renal disease patients with acute coronary syndrome with pulmonary edema? |
| title_sort | can peritoneal dialysis be continued as opposed to switching to hd in end stage renal disease patients with acute coronary syndrome with pulmonary edema |
| topic | Acute coronary syndrome chronic kidney disease hemodialysis end-stage kidney disease peritoneal dialysis pulmonary edema |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2534502 |
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