During the last six years 13 patients suffering from congestive heart failure (CHF), refractory to conventional medical treatment and classified class IV as defined by the New York Heart Association (NYHA), were treated with continuous ambulatory peritoneal dialysis (CAPD) (1) at Innsbruck University Hospital, Department of Internal Medicine. All patients required intensive care and were end-stage. The minimum observation period was six weeks, maximum 67 months. Cardiac recompensation was effected in all patients, who were stabilized in class II after NYHA. The patient with the shortest observation period of six weeks received an orthotopic heart transplant. None of the patients died of a CAPD-associated complication. All patients were restored to a normal life style without major dependence on outside help. The occurrence and treatment of the prerenal kidney failure that causes life-threatening problems in end-stage CHF should be subject to further study with regard to its clinical course and the determination of plasma-ANF, plasma-renin and plasma-aldosterone concentration.