Can chronic kidney disease lead to chronic heart failure, and does worsening chronic heart failure lead to chronic kidney disease progression

Abstract

Purpose of reviewThe objective of this review is to discuss if chronic kidney disease (CKD) leads to chronic heart failure (CHF), and does worsening CHF lead to CKD progression and how a new medication class can modify the risk of both outcomes. Recent findingsSodium-glucose cotransporter 2 (SGLT2) inhibitors are similarly effective on cardiovascular (CV) -and kidney-related outcomes in the presence of CV and CKD. SummarySGLT2 inhibitors can reduce the risk of CHF events and CKD progression, and may have synergistic effects in patients with cardiorenal syndrome.

Endothelin type A receptor blockade increases renoprotection in congestive heart failure combined with chronic kidney disease: Studies in 5/6 nephrectomized rats with aorto-caval fistula

“…Evidently, CKD is an exceptionally strong and independent risk factor for the progression of CHF. Furthermore, the present findings and long-term mortality and morbidity studies [2,4,5,7,8] indicate that 5/6 NX + ACF HanSD rats present an optimal model to study the pathophysiology and perform preclinical testing aimed to identify new targets for the treatment of combined CKD and CHF.…”

“…Nevertheless, the combined treatment displayed marked additional beneficial actions on albuminuria and important renoprotective effects, such as alleviation of the renal glomerular and cortical tubulointerstitial injury. Increased albuminuria is a strong and independent predictor for all-cause mortality in CKD as well as in CHF [3][4][5]7,8,53,55], hence with the prolonged treatment the additive beneficial actions on the course of CKD-and CHF-related mortality could occur. Such reasoning is supported by the favourable actions on renal glomerular and tubulointerstitial morphology: 5/6 + ACF HanSD rats treated within the late treatment protocol with either ET A antagonist alone or ACEi alone showed marked renal glomerular damage, similar as observed in untreated animals.…”

“…Almost 40% of CHF patients die within 1 year from the diagnosis and 70% within 5 years, even under adequate modern therapy [1,2]. The incidence and prevalence of chronic kidney disease (CKD) is also increasing [3] and CKD is one of the strongest risk factors for the development of CHF [4,5]. CHF coexists with CKD in approximately half of CHF patients [4][5][6][7][8].…”

“…The incidence and prevalence of chronic kidney disease (CKD) is also increasing [3] and CKD is one of the strongest risk factors for the development of CHF [4,5]. CHF coexists with CKD in approximately half of CHF patients [4][5][6][7][8]. Unfortunately, patients with estimated glomerular filtration rate ≤ 30 ml/min/1.73 m 2 have now largely been excluded from randomized control trials in HF, which limits the information on patients with combined CHF and CKD [4,5,7,8].…”

“…CHF coexists with CKD in approximately half of CHF patients [4][5][6][7][8]. Unfortunately, patients with estimated glomerular filtration rate ≤ 30 ml/min/1.73 m 2 have now largely been excluded from randomized control trials in HF, which limits the information on patients with combined CHF and CKD [4,5,7,8]. Therefore, although the patients with combined CHF and advanced CKD represent probably the highest cardiovascular risk population, their exclusion from CHF trials is a serious deontological error.…”