Kidney injury in cardiac transplant recipients is one of the most severe complications affecting both short- and long-term transplant outcomes. The need for renal replacement therapy (RRT) is determined not only and not so much by the degree of renal dysfunction, as by the need for correction of fluid balance and metabolic disorders. These circumstances are associated with the specificity of extracorporeal renal replacement therapy in donor heart recipients. In this review, we discuss the problems of early versus delayed initiation of RRT, anticoagulation and vascular access, advantages and disadvantages of continuous and intermittent techniques. Special attention is paid to chronic kidney injury and peculiarities of kidney transplantation in heart recipients.

The development of kidney injury and the characteristics of renal replacement therapy were considered in patient with dilated cardiomyopathy, who consequently underwent two heart transplantations and two kidney transplantations. Since the number of the patients needed both kidney and heart transplantation increases constantly, the multifaceted thorough research in this specific patient population is extremely important.

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