Kidney disease and heart failure: recent advances and current challenges: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference - PubMed

3 days ago

Heart failure (HF) and chronic kidney disease (CKD) often coexist, increasing risks of hospitalization, disease progression, and death.
The KDIGO Controversies Conference in March 2024 discussed the bidirectional relationship between HF and CKD, including shared risk factors and overlapping pathophysiology.
Challenges remain in diagnosing and managing HF and CKD together, including interpreting biomarkers like natriuretic peptides and serum creatinine.
Sodium-glucose cotransporter-2 inhibitors, RAAS inhibitors, and emerging agents like finerenone and GLP-1 receptor agonists show benefits in both HF and CKD patients.
Small declines in kidney function after starting guideline-directed HF therapies often do not require discontinuation as they are hemodynamic and not linked to poor outcomes.
The conference highlighted 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 is needed to improve care for patients with HF and CKD.

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