Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency

Damman, K., Tang, W.H. W., Felker, G. M., Lassus, J., Zannad, F., Krum, H. and McMurray, J. J.V. (2014) Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency. Journal of the American College of Cardiology, 63(9), pp. 853-871. (doi:10.1016/j.jacc.2013.11.031) (PMID:24334210)

Full text not currently available from Enlighten.

Abstract

Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients with (severe) renal dysfunction. The benefit of these evidence-based therapies in this high-risk patient group is largely unknown. This paper reviews data from randomized clinical trials in systolic heart failure and the interactions between baseline renal dysfunction and the effect of randomized treatment. It highlights that most evidence-based therapies show consistent outcome benefit in patients with moderate renal insufficiency (stage 3 CKD), whereas there are very scarce data on patients with severe (stage 4 to 5 CKD) renal insufficiency. If any, the outcome benefit might be even greater in stage 3 CKD compared with those with relatively preserved renal function. However, prescription of therapies should be individualized with consideration of possible harm and benefit, especially in those with stage 4 to 5 CKD where limited data are available.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMurray, Professor John and Damman, Dr Kevin
Authors: Damman, K., Tang, W.H. W., Felker, G. M., Lassus, J., Zannad, F., Krum, H., and McMurray, J. J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Journal of the American College of Cardiology
Publisher:Elsevier Inc.
ISSN:0735-1097
ISSN (Online):1558-3597

University Staff: Request a correction | Enlighten Editors: Update this record