Experience of managing a comorbid patient with chronic heart failure and chronic right-single kidney disease

Abstract

Introduction. The question of management tactics of comorbid patients remains the most difficult task in clinical practice. Combined cardiac and renal disorders (cardiorenal syndrome) are widespread in this category of patients and require close attention of the practitioner due to the emerging difficulties of drug therapy selection, in particular related to the limitations of prognostic-modifying drugs prescription. The aim of the study was to demonstrate on clinical example the peculiarities of comorbid patient management with combined cardiovascular and renal pathology. Materials and methods. Clinical case of patient R. with chronic heart failure and chronic disease of the only right kidney, the description of which highlights the key aspects that require attention in determining the tactics of comorbid patient management. Results. As a result of multicomponent personalized conservative therapy, the severity of dyspnea decreased, edema of the lower extremities was eliminated, regression of pleural effusion was achieved. Intensification of treatment was necessary during hospitalization due to exacerbation of chronic pyelonephritis of the right sole kidney, which helped improve the patient's condition. Conclusion. The most effective correction of each pathology improve the quality and life expectancy of a comorbid patient. Difficulties in achieving the target treatment results due to the interaction of several pathogenetic links potentiating each other should be overcome by selecting personalized therapy, as well as by searching for new therapeutic targets.