Reversal of stage 5 chronic kidney disease by aortic valve replacement in kidney transplant recipient: a case report.
BACKGROUND
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. 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.


CONCLUSIONS
The 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.
['Hryniewiecka|E|E|', 'Hryniewiecki|T|T|', 'Różański|J|J|', 'Pilecki|T|T|', 'Zagożdżon|R|R|', 'Orłowski|T|T|', 'Gołębiowski|M|M|', 'Pączek|L|L|', 'Mucha|K|K|', 'Foroncewicz|B|B|0000-0002-0757-4547']
D000328:Adult D001022:Aortic Valve Insufficiency D059347:Cardio-Renal Syndrome D006085:Graft Survival D006333:Heart Failure D019918:Heart Valve Prosthesis Implantation D006801:Humans D007166:Immunosuppressive Agents D016030:Kidney Transplantation D008297:Male D020127:Recovery of Function D006435:Renal Dialysis D051436:Renal Insufficiency, Chronic D012720:Severity of Illness Index D016896:Treatment Outcome
Aortic valve replacement Kidney transplantation Cardiorenal syndrome Acute-on-chronic Heart failure Aortic insufficiency End stage renal disease Haemodialysis