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Published on: June 10, 2025

10-Year Trends in Heart Failure Among Patients With Dialysis and Nondialysis CKD

Roosa Lankinen1, Shunsuke Murata2,3,4, Juan-Jesús Carrero1,5

  • 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Kidney International Reports
|August 11, 2026
PubMed

Insights

Heart failure hospitalization rates are increasing in advanced chronic kidney disease (CKD) patients, rising faster than in the general population. While heart failure mortality has declined, the growing hospitalization burden in CKD necessitates targeted interventions.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Advanced chronic kidney disease (CKD) significantly impacts cardiovascular health.
  • Heart failure (HF) is a major complication in patients with CKD.
  • Understanding temporal trends of HF in CKD is crucial for public health strategies.

Purpose of the Study:

  • To investigate the incidence rates and temporal trends of heart failure (HF) hospitalization and mortality in advanced chronic kidney disease (CKD) patients.
  • To compare these trends with the general population (GP).
  • To identify potential associations with medication use.

Main Methods:

  • Retrospective cohort study using the Swedish Renal Registry (2011-2021).
  • Included patients with CKD stages G4, G5, hemodialysis (HD), and peritoneal dialysis (PD).
  • Used Poisson models to estimate incidence rates (IR) and standardized IR compared to the GP.

Main Results:

  • HF hospitalization rates were 3.7 to 6.8 times higher in advanced CKD than in the GP.
  • Between 2011-2021, HF hospitalization rates increased significantly in CKD stages 4, 5-ND, and HD, exceeding the GP's increase.
  • HF-related mortality declined in CKD patients, but at a slower rate than in the GP.

Conclusions:

  • Despite declining mortality, HF hospitalization rates are rising substantially in advanced CKD, outpacing the general population.
  • These findings underscore the increasing burden of HF in CKD.
  • Targeted prevention and management strategies for HF in CKD are urgently needed.
Abstract

Keywords:
CKDdialysisdiureticsepidemiologyheart failuretemporal trends

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