Interrelation between heart failure with preserved ejection fraction and renal impairment

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• Heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD) are prevalent global conditions.
• CKD exacerbates HFpEF through mechanisms like inflammation and fibrosis, impacting patient prognosis.
• Dual diagnosis often involves older patients with more severe disease.

Purpose of the Study:

• To review the pathophysiological connections between HFpEF and CKD.
• To discuss the clinical presentation and implications of this dual diagnosis.
• To examine treatment challenges, particularly hyperkalemia, and emerging therapies.

Main Methods:

• Literature review of pathophysiological mechanisms linking HFpEF and CKD.
• Analysis of clinical data regarding co-diagnosis and prognosis.
• Evaluation of current and emerging pharmacological treatments for HFpEF in CKD patients.

Main Results:

• CKD is a significant negative prognostic factor in HFpEF.
• Acute kidney injury is common in decompensated HFpEF, with unclear long-term outcomes.
• Limited treatment options for HFpEF, especially with CKD and hyperkalemia concerns.

Conclusions:

• Understanding the interplay between HFpEF and CKD is crucial for patient management.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise for both HFpEF and renal outcomes.
• Further research is needed on HFpEF's impact on CKD prognosis and optimal treatment strategies.