Penn Medicine's Cardiorenal and Ultrafiltration Program provides comprehensive diagnosis and treatment for patients with cardiorenal syndrome (CRS). Cardiorenal syndrome is a condition characterized by abnormal heart function that is associated with abnormal kidney function.
Often times, kidney (renal) and cardiac disease occurs in conjunction with one another. For example, when a person experiences heart failure, many times they will also experience worsening kidney function. Heart failure is a condition where the heart cannot pump normal amounts of blood at normal filling pressures, resulting in the body retaining fluid. A decrease in either heart or kidney function can negatively affect the other organ.
Treatment for Cardiorenal Syndrome
At Penn, our expert physicians treat patients using a multidisciplinary approach. Penn nephrologists and cardiologists work closely together to create individualized treatment plans for patients with cardiorenal syndrome. This close collaboration ensures that patients receive personalized, high-quality care from both heart failure and nephrology specialists, in one place, at one time.
Removal of excess fluid from the body is a key part of heart failure treatment. This is usually done with medications called diuretics that increase urine production. Certain blood pressure medications can also help treat heart failure by decreasing the workload of the heart. Carefully balancing these medications is very important when treating heart failure. However, the use of these medications can present risks by impacting kidney function. Decreased kidney function may lessen the effects of diuretics, and removing fluid with diuretics may also have a negative impact on kidney function.
In more severe cases of cardiorenal syndrome, patients may be evaluated for advanced treatments including dialysis, heart transplantation as well as combined heart and kidney transplantation. For certain patients, ultrafiltration is also an option.
Ultrafiltration
Ultrafiltration is a mechanical fluid removal procedure designed to treat patients who have an excess of fluid in their bodies and have difficulty removing fluid with diuretics. The goal of treatment is to restore fluid balance in the body.
Common signs and symptoms of excessive fluid retention include:
- Weight gain
- Swelling of the legs, ankles and feet
- High blood pressure
- Fatigue
- Trouble breathing when lying down
- Swelling in the stomach or abdomen
Ultrafiltration is done in the hospital because it is important to monitor the speed of fluid removal so that patients can tolerate the procedure safely. During the procedure a small catheter is placed in a vein, usually in the arm. The catheter brings blood to the ultrafiltration machine, and then back to the patient. The machine is placed on wheels and is small enough so that patients can walk around during treatment. A patient is given a blood thinner to keep the machine from clotting. After the procedure, diuretics are restarted to maintain fluid balance.