RT Generic
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 Nunez, 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
K1 Reduced ejection fraction
K1 Glomerular-filtration-rate
K1 Atherosclerosis risk
K1 Renal-insufficiency
K1 Cardiovascular risk
K1 All-cause
K1 Outcomes
K1 Classification
K1 Epidemiology
K1 Albuminuria
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 univ press
SN 2048-8505
YR 2022
FD 2022-01-27
LK https://hdl.handle.net/10668/25520
UL https://hdl.handle.net/10668/25520
LA en
DS RISalud
RD Apr 9, 2025