Abstract
When heart failure (HF) becomes refractory to treatment, symptomatic palliation becomes a primary goal. This is especially true for elderly patients who are not candidates for heart transplantation, and end-of-life care becomes a primary focus. Hemofiltration therapy is a relatively straightforward method of fluid management to initiate, but its indication is limited to symptoms based on renal function or end-stage renal failure. In this case report, we investigated the background and course of elderly end-stage HF patients with chronic kidney disease who underwent hemodialysis (HD) for treatment-resistant HF. We studied 10 patients with an average age of 82 years, 7 of whom had HF with preserved left ventricular ejection fraction. All patients required oxygen therapy at the time of dialysis induction, but none had uremia. Four patients died after HD induction, but there were no cases of fluid management failure during the follow-up period. Although the patients were initially targeted for transition to end-of-life care, the introduction of HD contributed to short-term improvement in HF symptoms. These results suggest that HD may be effective in improving refractory HF symptoms in the elderly population.
