Das kardiorenale Syndrom

Abstract

In patients with chronic cardio renal syndrome chronic heart disease coexists with chronic kidney disease and poses the patients to a specifically high risk for cardiovascular events and mortality. Treatment recommendations in this condition with a high level of evidence are sparse. Mainstay of therapy in cardiorenal syndrome is fluid metabolism control and stabilization of renal and cardiac function, which can basically been achieved by substances modifying the renin-angiotensin-aldosterone-system as well as diuretics. Noteworthy, despite inducing short-term decreases in renal function, inhibition of the RAAS and diuretic medication associate with the long-term improvements of outcome (so-called pseudo-worsening of renal function). The chronic cardiorenal syndrome calls for interdisciplinary care by both nephrologists and cardiologists in order to allow high-end patient care with a maximum of beneficial effect and a minimum of treatment-related side effects.

Die Bezeichnung der Erkrankung umfasst bereits ihre Besonderheit, nämlich die Interaktion zwischen Herz- und Nierenerkrankungen. Hierbei ist nachhaltig die Fähigkeit erschwert, den Elektrolyt- und Wasserhaushalt zu regulieren. KRS-Patienten sind Hochrisikopatienten, und ihre Therapie profitiert vom Fachwissen beider beteiligter Disziplinen, der Kardiologie und der Nephrologie. Wo jeweils die Schwerpunkte zu setzen sind, zeigt dieser Beitrag.

Schlüsselwörter

Herzinsuffizienz - chronische Niereninsuffizienz - Therapie - Verschlechterung der Nierenfunktion - Renin-Angiotensin-Aldosteron-System

Key words

heart failure - chronic kidney disease - treatment - worsening of renal function - renin-angiotensin-aldosterone-system

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