Challenges and Opportunities in Titrating Disease-Modifying Therapies in Heart Failure with Reduced Ejection Fraction and Chronic Kidney Disease.
Stefana EnachiMaxime SchleefChahr-Eddine HadjseydSimon LeboubeCharles FauvelLucie DanielAntoine Jobbe-DuvalLaurent SebbagSandrine LemoineNathan MewtonPublished in: Current heart failure reports (2023)
Despite limited data, studies show that HFrEF therapies maintain their benefits on cardiovascular outcomes in patients with CKD. Most HF drugs cause acute renal haemodynamic changes, but with stabilisation or even improvement after the acute phase, thus with no long-term worsening of the renal function. In this expert opinion-based paper, we challenge the pathophysiology misunderstandings that impede HF disease-modifying therapy implementation in this setting and propose a strategy for HF drug titration in patients with moderate, severe, and end-stage chronic kidney disease.
Keyphrases
- chronic kidney disease
- acute heart failure
- end stage renal disease
- heart failure
- drug induced
- liver failure
- primary care
- healthcare
- electronic health record
- respiratory failure
- high intensity
- quality improvement
- big data
- machine learning
- case control
- cardiac resynchronization therapy
- deep learning
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- smoking cessation