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Peritoneal Ultrafiltration and Heart Failure: from Icodextrin to NYHA Class

Is peritoneal ultrafiltration a useful therapeutic alternative in diuretic resistant heart failure, even in patients with preserved glomerular filtration rate? Some recent clinical trials, here briefly analysed, reported the positive effects of peritoneal ultrafiltration on NYHA class, hospitalization rates and quality of life of decompensated patients. Why this technique has so little fortune among Nephrologists?