Heart failure is not only a global problem but also significantly limits the life
prospects of these patients. The epidemiology and presentation of heart failure are
intensively researched topics in cardiology. The risk factors leading to heart failure
are well known; however, the real challenge is to provide effective treatments. A
vicious cycle develops in heart failure of all etiologies, sooner or later compromising
both cardiac and kidney functions simultaneously. This can explain the repeated hospital
admissions due to decompensation and the significantly reduced quality of life. Moreover,
diuretic-refractory heart failure represents a distinct challenge due to repeated
hospital admissions and increased mortality. In our narrative review, we wanted to
draw attention to nephrology treatment options for severe diuretic-resistant heart
failure. The incremental value of peritoneal dialysis in severe heart failure and
the feasibility of percutaneous peritoneal dialysis catheter insertion have been well
known for many years. In contrast, the science and narrative of acute peritoneal dialysis
in diuretic-resistant heart failure remains underrepresented. We believe that nephrologists
are uniquely positioned to help these patients by providing acute peritoneal dialysis
to reduce hospitalization dependency and increase their quality of life.
