PD-HF: A Trial of Peritoneal Dialysis in Patients With Severe Heart Failure and Chronic Kidney Disease

Inclusion Criteria: * Severe heart failure (NYHA grade III or IV) * Chronic kidney disease stage 3-4 * Fluid overload resistant to diuretics OR hospital admission for HF in last 6 months * Left ventricular ejection fraction ≤40% in last 2 years (moderate/severe) * Using optimal HF medication for ≥ 4 weeks including ACE-inhibitor (angiotensin-converting-enzyme inhibitor) OR angiotensin receptor blocker AND aldosterone antagonist AND beta-blocker unless intolerant and without dose change for ≥ 4 weeks * Appropriately screened for revascularization and/or cardiac resynchronization therapy if clinically indicated. Exclusion Criteria: * Does not wish to participate * Mental incapacity to consent * CKD stage 5 * Normal renal excretory function * Haemodynamically significant valvular disease amenable to surgery * Cardiac or renal transplantation * Considered by the investigator to unsuitable for PD due to previous abdominal surgeries, peritonitis, social circumstances or other reason