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
