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.
© Georg Thieme Verlag KG Stuttgart · New York.