Unforeseen renal pathological findings in a patient with type 2 cardiorenal syndrome who died after 4 years of continuous ambulatory peritoneal dialysis.

A man in his 30s with dilated cardiomyopathy was admitted to our hospital with heart failure exacerbation. Despite optimal medical treatment, his renal function progressively declined to end-stage renal failure. Type 2 cardiorenal syndrome (CRS) was diagnosed and continuous ambulatory peritoneal dialysis was started. He died of a brainstem infarction 4 years later. Postmortem renal pathology revealed no significant changes in the glomeruli except for shrinkage, normal arterioles and focal degeneration of the tubules with peritubular fibrosis. This suggests that renal replacement therapy can be withdrawn from some patients with type 2 CRS.