Cardiorenal Syndrome in Chronic Heart Failure Patient with Severe Arrhythmia

Melissa1, Jansen Chitrahadinata1, Debora Nurhadi2

1
Sumber Waras Hospital, DKI Jakarta
2
Laboratory Department of Sumber Waras Hospital, DKI Jakarta

ABSTRACT

Background: The maintenance of body’s hemodynamic stability depends on the heart

performance and renal function. Both organs’ work are interconnected that the damage of
the heart lead to the dysfunction of renal and vice versa. Nowadays, there are many cases
when heart disease lead to renal dysfunction, or renal damage induce to heart failure.
Cardiorenal syndrome, the term used for the condition, has caused significant increase in
both mortality and morbidity, complexity of the treatment, and expensive cost of care.
Case Description: A 54 year old male with history of Chronic Heart Failure, presented with
difficulty of breathing and epigastric pain. His ECG showed severe arrhythmia of
ventricular tachycardia. He was observed in Intensive Care after being treated with
synchronized cardioversion . His blood test’s result showed a high level of BNP (2.610
pg/mL) with an increased creatinine level (2,1 mg/dL). After being treated with heparin,
continuous intravenous furosemide and isorbid for nine days, his creatinine level became
normal again (1,1 mg/dL).
Conclusion: In both heart failure and severe arrhythmias, acute lowering of cardiac output
lead to hemodynamic instability and renal injury. With adequate treatment in early stage,
the impairment of the renal could be avoided. Thus, it is important to recognize and aware
of the possibility of kidney injury in heart failure.
Keywords: cardiorenal syndrome, heart failure, kidney injury, biomarkers, severe
arrhythmias.