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<p>If it needs to be particularly thorough, the Germans have a&#xa0;phrase for it: “<i>auf Herz und Nieren prüfen</i>”, or check the heart and the kidneys, maybe best translated with “put through its paces”, as previously the heart and kidneys were regarded as the center of the life force. In reality kidney diseases are not looked for in a&#xa0;systematic way, at least not in Germany. It surely makes sense to consider both organs together as approximately 15% of the adult population in the USA suffer from chronic kidney disease (CKD), 2% from heart failure and 9% from cardiovascular disease. The overlap between these three entities is large. Data from the United States Renal Data Systems (USRDS) concerning the mortality of dialysis patients in 2022 show that cardiovascular diseases are the leading cause of death. Of the hemodialysis (HD) and peritoneal dialysis (PD) patients 47.1% and 42.1%, respectively, die of sudden cardiac death, which is frequently the end of a chronic heart failure and coded with 3.0% and 2.9% as the cause of death on HD. For severe heart failure with an ejection fraction &lt; 30% PD is frequently the preferred procedure. In an ideal setting the cardiorenal team should discuss not only the vascular access for a cardiac catheter examination (femoral instead of brachial for protection of potential shunt arteries) but also the choice of pacemakers and implantable cardioverter defibrillators (leadless devices whenever possible).</p>

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Auf Herz und Nieren behandeln

  • 期刊论文

  • 发表日期：

    2025年1月20日

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  • Amelie Gienapp,
  • Jan Ballof,
  • Dana Zeinert,
  • Torsten M. Meyer,
  • Manuela Lindgren,
  • Gabriele Eden,
  • Tibor Kempf,
  • Jan T Kielstein

摘要

If it needs to be particularly thorough, the Germans have a phrase for it: “auf Herz und Nieren prüfen”, or check the heart and the kidneys, maybe best translated with “put through its paces”, as previously the heart and kidneys were regarded as the center of the life force. In reality kidney diseases are not looked for in a systematic way, at least not in Germany. It surely makes sense to consider both organs together as approximately 15% of the adult population in the USA suffer from chronic kidney disease (CKD), 2% from heart failure and 9% from cardiovascular disease. The overlap between these three entities is large. Data from the United States Renal Data Systems (USRDS) concerning the mortality of dialysis patients in 2022 show that cardiovascular diseases are the leading cause of death. Of the hemodialysis (HD) and peritoneal dialysis (PD) patients 47.1% and 42.1%, respectively, die of sudden cardiac death, which is frequently the end of a chronic heart failure and coded with 3.0% and 2.9% as the cause of death on HD. For severe heart failure with an ejection fraction < 30% PD is frequently the preferred procedure. In an ideal setting the cardiorenal team should discuss not only the vascular access for a cardiac catheter examination (femoral instead of brachial for protection of potential shunt arteries) but also the choice of pacemakers and implantable cardioverter defibrillators (leadless devices whenever possible).