Cardiorenal Interactions Revisited: How to Improve Heart Failure Outcomes in Patients With Chronic Kidney Disease
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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).
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.
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.
KeywordsHeart failure Chronic kidney disease Renal failure Cardiorenal Outcome
Compliance with Ethical Standards
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.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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