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Nephrologie aktuell 2023; 27(04): 160-168
DOI: 10.1055/a-2008-2179
Schwerpunkt
Dialyse

Ultrafiltration bei kardiorenalem Syndrom

Grenzen konservativer Therapie und Indikation zur Ultrafiltration
Moritz Schanz
1   Abteilung für Allgemeine Innere Medizin und Nephrologie, Robert-Bosch-Krankenhaus, Stuttgart
,
Jörg Latus
1   Abteilung für Allgemeine Innere Medizin und Nephrologie, Robert-Bosch-Krankenhaus, Stuttgart
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ZUSAMMENFASSUNG

Das kardiorenale Syndrom (KRS) umfasst heterogene Erkrankungen von Herz und Niere, die im Wesentlichen durch eine wechselseitige Funktionsstörung von Herz und Nieren gekennzeichnet sind. Das häufig führende Symptom ist die Überwässerung, für die therapeutisch neben der klassischen diuretischen Behandlung auch interventionelle Verfahren zur Verfügung stehen. Die konservativen Therapiemöglichkeiten geraten gerade bei eingeschränkter Nierenfunktion oftmals an ihre Grenzen – trotz neuerer Kombinationstherapien zur Steigerung der diuretischen Effektivität mit SGLT2-Inhibitoren (SGLT2: „sodium glucose linked transporter 2“) oder Carboanhydrasehemmern. Interventionelle Verfahren kommen bei therapierefraktärer Herzinsuffizienz daher entweder zur isolierten Ultrafiltration bei alleiniger Volumenüberladung oder zur Nierenersatztherapie mittels Hämo- oder Peritonealdialyse zum Einsatz. Bei letzterer ist die Peritonealdialyse als besonders vorteilhaft hervorzuheben aufgrund der kontinuierlichen Ultrafiltration mit einer höheren hämodynamischen Stabilität, positiven kardialen Effekten und einer hohen Patientenautonomie.



Publication History

Article published online:
31 May 2023

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