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Cardiorenal Interactions Revisited: How to Improve Heart Failure Outcomes in Patients With Chronic Kidney Disease

  • Comorbidities of Heart Failure (C. Angermann, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

To summarize current advances in the understanding and management of heart failure (HF) in patients with advanced chronic kidney disease (CKD).

Recent Findings

Diagnosis of HF and treatment of congestion are crucial in the management of patients with advanced CKD to reduce symptoms, preserve organ function, and improve outcomes. Echocardiography and cardiovascular biomarkers may help to differentiate cardiac from non-cardiac components of overhydration. Renal replacement therapy or ultrafiltration may be required to treat congestion. Furthermore, patients with advanced CKD are frequently undertreated with disease-modifying HF therapies, but the use of beta-blockers and ACEi should be considered under close monitoring of kidney function and serum potassium. The use of the new oral potassium binders may translate into improved outcomes.

Summary

The treatment of HF in patients with advanced CKD requires a multi-disciplinary approach. New diagnostic and therapeutic strategies are under evaluation and may contribute to improved outcomes.

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Authors and Affiliations

  1. Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Mattia Arrigo

  2. Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA, USA

    Pietro E. Cippà

  3. INSERM UMR-S 942, Paris, France

    Alexandre Mebazaa

  4. University Paris Diderot, Sorbonne Paris Cité, Paris, France

    Alexandre Mebazaa

  5. Department of Anesthesiology and Critical Care Medicine, St. Louis and Lariboisère University Hospitals, Paris, France

    Alexandre Mebazaa

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  1. Mattia Arrigo
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  2. Pietro E. Cippà
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  3. Alexandre Mebazaa
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Correspondence to Mattia Arrigo.

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Conflict of Interest

Pietro E. Cippà declares no conflict of interest. Dr. Arrigo reports personal fees from Orion Pharma, outside the submitted work. Dr. Mebazaa reports personal fees from Novartis, Orion, Roche, Servier, Cardiorentis, Neuro Tronik, and Zs Pharma and grants and personal fees from Adrenomed. He also reports grants from MyCartis and Critical diagnostics, grants and personal fees from Abbott, and grants and personal fees from Sphyngotec, all of which are outside the submitted work. In addition, Dr. Mebazaa has a patent WO2017077117 issued.

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This article is part of the Topical Collection on Comorbidities of Heart Failure

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Arrigo, M., Cippà, P.E. & Mebazaa, A. Cardiorenal Interactions Revisited: How to Improve Heart Failure Outcomes in Patients With Chronic Kidney Disease. Curr Heart Fail Rep 15, 307–314 (2018). https://doi.org/10.1007/s11897-018-0406-8

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