Kidneys in heart failure: Impact of flozins and beyond

Kardiol Pol. 2023 Nov 8. doi: 10.33963/v.kp.97844. Online ahead of print.ABSTRACTChronic kidney disease (CKD) and heart failure (HF) represent two modern epidemies and are closely related. According to the concept of cardio-renal and reno-cardiac syndromes most of patients with CKD are affected by cardiovascular disease (CVD) and CVD (including HF) is one of the factors not only promoting progression of established CKD, but also triggering its onset and development. Treatment of CVD and HF in CKD patients remains to be challenging since CKD patients are characterized by extremely diverse and strongly expressed risk profile and the data from well-designed clinical trials addressing this population are scarce. Nevertheless, it seems that most of the drugs used in the treatment of CVD and HF (including: beta-blockers, ACE inhibitors, angiotensin II receptor blocking agents, mineralocorticosteroid receptor antagonists and sacubitril/valsartan) are of similar efficacy in patients with glomerular filtration rate (GFR) ranging between 45 and 60 ml/min/1.73 m² (although higher prevalence of side effect may limit their use). The data on cardiovascular (CV) drug efficacy in patients with lower GFR values (i.e. below 30-45 ml/min/1.73 m²) remains limited. In this review we focused on the efficacy of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the treatment of CVD and HF in patients with CKD with or without diabetes. Sodium-glucose co-transporter type 2 inhibitors (SGLT2i) ar...
Source: Polish Heart Journal - Category: Cardiology Authors: Source Type: research