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Pharmacologic therapy in patients with chronic heart failure and chronic kidney disease: a complex issue
Nicola Acquarone1, Cristoforo Castello, Giancarlo Antonucci
1Struttura Complessa di Medicina Interna, Ente Ospedaliero Ospedali Galliera, Genoa, Italy. nicola.acquarone@galliera.it
Abstract:
Chronic kidney disease is common in patients with chronic heart failure and has important clinical implications. The coexistence of these two syndromes is associated with a higher risk of adverse outcome and increases the difficulties of heart failure treatment because of the complex interplay between renal dysfunction and pharmacologic therapy. The underrepresentation of patients with chronic kidney disease in most heart failure trials contributes to the suboptimal treatment of this high-risk population in clinical practice. In the present review, we briefly examine the pathophysiologic mechanisms connecting chronic kidney disease and chronic heart failure and discuss the therapeutic approach to patients affected by both conditions.
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