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Kidney dialysis and congestive heart failure
An_242721 posted:
My 91 year old father is hospitalized with congestive heart failure, and his kidneys have stopped functioning. We were told that kidney dialysis puts a strain on his heart. Why is that? What is the relationship between congestive heart failure and kidney dialysis?
john-skpt responded:
The basic problem is that hemodialysis causes very big changes in blood pressure, blood volume, electrolyte balance very suddenly. (Kidneys normally are working 24 hours a day, 7 days a week, and doing it very gently. The machine has to do all that work in 3 or 4 hours, 3 times a week. So things are a lot more drastic, and that places additional load on the heart and the arteries.)

There are a couple of potential (and I emphasize 'potential') options, but these are generally only appropriate for patients with better overall health: One might be peritoneal dialysis. This can take place at home, and tends to be a little more gentle on the cardiovascular system.But it demands an alert and very attentive patient since for the most part, doctors are not involved from day to day. The second option might be home or nocturnal hemodialysis, which can be done more often and slower and more gently than the 3 days a week method. But again this demands a very involved and attentive patient, and it is far costlier.

So unfortunately, if the patient is confined to hospital, then that indicated that the CHF is already pretty serious. So there may not be a lot of options right at the moment, other than to treat the CHF and hope that the renal issues resolve once the heart and vascular issues are a bit stable.

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