[Heart and kidney--only together they are strong. On the cardiorenal and renocardiac syndrome. Case 5/2011]. / Herz und Nieren--nur gemeinsam sind sie stark. Über das kardiorenale und renokardiale Syndrom. Fall 5/2011.

ABSTRACT

HISTORY AND ADMISSION FINDINGS: We report on two patients with cardiorenal and renocardiac syndrome, respectively, who were treated with peritoneal dialysis. INVESTIGATIONS Patient 1 suffered from dilated cardiomyopathy with an ejection fraction of 20%. There was no hint for an intrinsic renal disease, urinalysis showed microalbuminuria at the most. Due to progressive cardiac forward failure kidney dysfunction and diuretic-refractory volume retention developed. Patient 2 was admitted with an uremic syndrome and newly developed atrial fibrillation. Echocardiography revealed a hitherto unknown dilated cardiomyopathy. DIAGNOSIS, TREATMENT AND COURSE Both patients were treated with continuous ambulatory peritoneal dialysis. This led to regression of the uremic complications. Sinus rhythm was restored in patient 2 after two weeks and cardiomyopathy was reversed after another 9 months. CONCLUSIONS: End-stage heart failure results in kidney dysfunction which can progress to a dialysis-dependent state. End-stage renal failure is often accompanied by cardiac dysfunction and failure.