Pre-heart failure in early chronic kidney disease: clinical epidemiology and treatment - PubMed

7 hours ago

Chronic kidney disease (CKD) affects 10%-15% of adults worldwide and is a powerful independent risk factor for cardiovascular diseases, including heart failure.
In early CKD stages (G1-G3), especially with albuminuria, mild reductions in eGFR are associated with subclinical cardiac abnormalities like left ventricular hypertrophy and diastolic dysfunction.
Many CKD patients meet Stage B heart failure criteria within the 'pre-HF' framework, based on structural/functional cardiac changes and elevated biomarkers without symptoms.
Detection is challenging due to non-specific symptoms and confounding of biomarkers by reduced renal clearance; echocardiography and cardiac MRI are sensitive tools but not routinely recommended for screening.
Management includes aggressive control of risk factors and therapies with cardiorenal benefits, such as SGLT2 inhibitors, finerenone, and renin-angiotensin system blockers.
Future research should focus on cost-effective diagnostic strategies, imaging/biomarker roles in therapy guidance, and multiomics/artificial intelligence for personalized prevention.

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