Abstract
BackgroundCardiorenal syndrome (CRS) is a group of pathophysiological disorders affecting heart and kidneys.Case presentationWe present 44-year-old kidney transplant recipient with acute-on-chronic graft failure in the course of CRS due to acutely decompensated heart failure associated with severe aortic regurgitation successfully treated with aortic valve replacement. Because of graft failure progression and difficult to eradicate infections he was treated with dialysis and radical minimization of immunosuppression. After 74 days of renal replacement therapy the patient regained graft function after successful aortic valve replacement. The dialysis could be stopped and immunosuppressive therapy was reintroduced. Heart and renal function are stable and patient is doing well without dialysis for 3 years.ConclusionsThe return of kidney graft function can occur even after a long period of dialysis therapy due to improved cardiovascular function. Therefore, distinguishing an acute-on-chronic CRS subtype is mandatory to enable specific patient approach.
Highlights
Cardiorenal syndrome (CRS) is a group of pathophysiological disorders affecting heart and kidneys.Case presentation: We present 44-year-old kidney transplant recipient with acute-on-chronic graft failure in the course of CRS due to acutely decompensated heart failure associated with severe aortic regurgitation successfully treated with aortic valve replacement
We present kidney transplant recipient with CRS due to acutely decompensated Heart failure (HF) associated with severe Aortic regurgitation (AR) successfully treated with aortic valve replacement (AVR)
Based on the above findings, the following diagnoses were established: bilateral lobar pneumonia with infected emphysematous bulla of the right lung, culture-negative aortic valve infective endocarditis (IE), AV disease with severe AR and biventricular HF decompensation overlapping with chronic graft nephropathy with kidney insufficiency requiring hemodialysis
Summary
The return of kidney graft function can occur even after a long period of dialysis therapy due to improved cardiovascular function.
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