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[Current aspects of heart-kidney interactions : Summary of important clinical studies from 2020]

Insa E Emrich1, Mert Tokcan2, Hussam Al Ghorani2

  • 1Klinik für Innere Medizin III, Klinik für Kardiologie, Angiologie und Internistische Intensivmedizin, IMED, Universitätsklinikum des Saarlandes, Homburg, Deutschland. insa.emrich@uks.eu.

Herz
|June 9, 2021
PubMed

Insights

New studies show sodium-glucose linked transporter 2 (SGLT2) inhibitors and finerenone improve outcomes for chronic kidney disease patients. Research also explored heart-kidney interactions, transcatheter aortic valve implantation, and acute kidney injury treatments.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Patients with chronic kidney diseases (CKD) face significantly higher risks of cardiovascular morbidity and mortality.
  • Understanding the intricate heart-kidney interactions is crucial for improving patient prognosis.

Purpose of the Study:

  • To summarize and discuss recent pivotal studies concerning heart-kidney interactions in CKD.
  • To evaluate the impact of novel pharmacological and interventional treatments on cardiovascular and renal outcomes in CKD patients.

Main Methods:

  • Review and synthesis of findings from key clinical trials including DAPA-CKD, SCORED, and FIDELIO-DKD.
  • Analysis of data from studies investigating transcatheter aortic valve implantation (TAVI) and MitraClip® implantation in relation to renal function.
  • Discussion of randomized studies on initiating kidney replacement therapy in acute kidney injury.

Main Results:

  • Sodium-glucose linked transporter 2 (SGLT2) inhibitors (dapagliflozin, sotagliflozin) demonstrated improved prognosis in CKD patients, with or without diabetes.
  • Finerenone, a novel mineralocorticoid receptor antagonist, showed promise for treating diabetic nephropathy.
  • Studies on TAVI and MitraClip® provided insights into their effects on renal function, informing future treatment recommendations.

Conclusions:

  • Emerging therapies like SGLT2 inhibitors and finerenone represent significant advancements in managing CKD and its cardiovascular complications.
  • Further research into interventional procedures and optimal timing for renal replacement therapy is essential for refining clinical guidelines.

Keywords:
Cardiovascular morbidityChronic renal insufficiencyMineralocorticoid receptor antagonistsRenal replacement therapySGLT2 inhibitors

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