There is a widening gap between the needs and possibilities of kidney transplantation. In order to solve the problem of organ shortage, the selection criteria for kidney donors have been less stringent over the last years. Favorable outcome of renal transplantation from deceased donors with acute renal failure requiring dialysis may have an important role in expanding the pool of donors. We present the case of two renal transplantations from a polytraumatized 20-years old donor with acute renal failure requiring dialysis. One recipient established good diuresis from the first post-transplant day and did not require hemodialysis. The second recipient had delayed graft function and was treated with 8 hemodialysis sessions. The patient was discharged with good diuresis and normal serum creatinine. After two years of follow-up, both recipients have normal graft function. According to our experience, kidneys from deceased young donors with acute renal failure requiring dialysis may be transplanted, in order to decrease the number of patients on transplantation waiting lists.

The leading causes of death in patients with chronic kidney disease (CKD) are cardiovascular diseases, regardless of the stage of disease or method of renal replacement therapy. On the other hand, CKD is a major risk factor for cardiovascular complications after acute myocardial infarction, as well as for adverse outcome in patients with chronic heart failure. In the present study we prospectively followed-up nephrological interventions in cardiology wards in order to determine changes in indications, treatment possibilities and outcome of patients. All patients treated at cardiology ward of the Clinical Hospital Centre Zagreb and requiring renal replacement therapy from January 2003 to December 2009 were included in the investigation. Cardiology hospital unit (intensive care or regular hospital cardiology ward), age, gender, Sepsis-related Organ Failure Assessment (SOFA) score, indication for dialysis, primary diagnosis, vascular access, methods of treatment, number of treatments, prescribed and delivered dose of dialysis and outcome were recorded. Patients were followed up until death during hospitalization or discharge from the hospital. From January 2003 to December 2009, 251 patients had been hospitalized at different cardiology wards and required renal replacement therapy. Mean age was 64.95 years (range 22 to 97 years), and there were 27.8% female patients. 52.9% of patients were hospitalized in the coronary intensive care unit. SOFA score had increased during the observed period from average 6.5 in 2003 to 13.45 in 2009. Specific knowledge with close collaboration between nephrologists and cardiologists is needed to achieve optimal outcome in this complex condition.