RT Journal Article
T1 The unmet need of evidence-based therapy for patients with advanced chronic kidney disease and heart failure: Position paper from the Cardiorenal Working Groups of the Spanish Society of Nephrology and the Spanish Society of Cardiology.
A1 Ortiz, Alberto
A1 Navarro-Gonzalez, Juan F
A1 Nuñez, Julio
A1 de la Espriella, Rafael
A1 Cobo, Marta
A1 Santamaria, Rafael
A1 de Sequera, Patricia
A1 Diez, Javier
K1 Advanced chronic kidney disease
K1 Heart failure
K1 Kidney failure
K1 Kidney replacement therapy
AB Despite the high prevalence of chronic kidney disease (CKD) and its high cardiovascular risk, patients with CKD, especially those with advanced CKD (stages 4-5 and patients on kidney replacement therapy), are excluded from most cardiovascular clinical trials. It is particularly relevant in patients with advanced CKD and heart failure (HF) who have been underrepresented in many pivotal randomized trials that have modified the management of HF. For this reason, there is little or no direct evidence for HF therapies in patients with advanced CKD and treatment is extrapolated from patients without CKD or patients with earlier CKD stages. The major consequence of the lack of direct evidence is the under-prescription of HF drugs to this patient population. As patients with advanced CKD and HF represent probably the highest cardiovascular risk population, the exclusion of these patients from HF trials is a serious deontological fault that must be solved. There is an urgent need to generate evidence on how to treat HF in patients with advanced CKD. This article briefly reviews the management challenges posed by HF in patients with CKD and proposes a road map to address them.
PB Oxford University Press
SN 2048-8505
YR 2021
FD 2021-12-23
LK http://hdl.handle.net/10668/19741
UL http://hdl.handle.net/10668/19741
LA en
NO Ortiz A, Navarro-González JF, Núñez J, de la Espriella R, Cobo M, Santamaría R, et al. The unmet need of evidence-based therapy for patients with advanced chronic kidney disease and heart failure: Position paper from the Cardiorenal Working Groups of the Spanish Society of Nephrology and the Spanish Society of Cardiology. Clin Kidney J. 2021 Dec 23;15(5):865-872
DS RISalud
RD Jul 1, 2025