Kidney Disease and Heart Failure: Recent Advances and Current Challenges: Conclusions From a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference - PubMed

5 days ago

Heart failure (HF) and chronic kidney disease (CKD) often coexist, increasing risks of hospitalization, disease progression, and death.
Diagnosing and managing HF and CKD together remains challenging despite independent treatment advances.
The KDIGO conference highlighted the bidirectional relationship between HF and CKD, including shared risk factors and overlapping pathophysiology.
Biomarkers like natriuretic peptides and serum creatinine require nuanced interpretation in HF and CKD.
Sodium-glucose cotransporter-2 inhibitors, renin-angiotensin-aldosterone system inhibitors, and emerging agents like finerenone and GLP-1 receptor agonists benefit both HF and CKD patients, though evidence in advanced CKD is limited.
Small declines in kidney function after starting guideline-directed HF therapies often do not require discontinuation, as they are usually hemodynamic and not linked to poor outcomes.
The conference emphasized the need for CKD-specific HF diagnostic thresholds and refined acute kidney injury definitions in HF.
Future trials should include relevant endpoints like kidney function trajectories, symptom burden, and quality of life.
An integrated, individualized approach to managing HF and CKD is essential for improving care.

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