title: [Cardiorenal syndrome: limits of heart failure therapy].
abstract: The cardiorenal syndrome is an interdisciplinary challenge with increasing health economic relevance. Renal failure is a strong predictor for mortality in patients with severe congestive heart failure (CHF) and CHF is one of the fastest increasing morbidities in western countries. For successful therapy a close cooperation between cardiology und nephrology is required. Moreover, a good compliance of the patient is needed to improve symptoms and to reduce the frequency of cardiac decompensation. A broad cardiological and nephrological evaluation and consideration of optimal conservative options according to national and international guidelines are essential. However, a renal replacement therapy might be helpful in patients with refractory heart failure even if they are not dialysis-dependent. In cases of acute heart and renal failure an intensive care management might be necessary to reduce volume overload with the help of extracorporeal ultrafiltration or a dialysis modality. Nevertheless, in cases of chronic refractory CHF peritoneal dialysis should be preferred. The first analysis of the registry of the German Society of Nephrology (http://www.herz-niere.de) confirmed that there is a benefit for health-related quality of life in chronic CHF patients treated with peritoneal dialysis.
authors.affiliation: Sektion Nephrologie, Medizinische Universitätsklinik Heidelberg, Im Neuenheimer Feld 162, 69120, Heidelberg, Deutschland, leonie.grossekettler@med.uni-heidelberg.de.
authors.forename: L
authors.initials: L
authors.lastname: Großekettler
authors.forename: B
authors.initials: B
authors.lastname: Schmack
authors.forename: V
authors.initials: V
authors.lastname: Schwenger
mesh_terms: D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005112:Extracorporeal Circulation / Q000401:mortality*; D006801:Humans; D015995:Prevalence; D017582:Renal Replacement Therapy / Q000401:mortality*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents