Cited by 122Heart Failure Treatment and ManagementChronic Kidney Disease and DiabetesAcute Kidney Injury Research

Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

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Damman, Kevin, Tang, W.H. Wilson, Felker, G. Michael, Lassus, Johan, Zannad, Faiez, Krum, Henry, McMurray, John J.V.·2014·Journal of the American College of Cardiology

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.

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  1. Damman et al. JACC Vol. 63, No. 9, 2014 Treatment of Patients With Heart Failure and Renal Insufficiency March 11, 2014:853-71

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Authors
Damman, K., Tang, W. H. W., Felker, G. M., Lassus, J., Zannad, F., Krum, H., & McMurray, J. J. V.
Affiliations
  • University Medical Center Groningen (NL)
  • Cleveland Clinic (US)
  • Duke University (US)
  • Helsinki University Hospital (FI)
  • Inserm (FR)
  • Monash University (AU)
  • University of Glasgow (GB)
Corresponding author
Damman, Kevin
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2014-03
Volume
63
Issue
9
Pages
853-871
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2117478922
Cited by
122
References
90
Citations by year
2026: 4 · 2025: 11 · 2024: 3 · 2023: 3 · 2022: 11 · 2021: 12 · 2020: 11 · 2019: 16 · 2018: 10 · 2017: 9 · 2016: 15 · 2015: 13 · 2014: 3 · 2012: 1
FWCI
1.76
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders
  • Netherlands Heart Institute
  • European Society of Cardiology Heart Failure Association Research Grant
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Keywords
chronic systolic heart failure, chronic kidney disease, renal failure, evidence-based treatment, treatment outcomes, CKD stages 3-5, personalized treatment
MeSH terms
Mineralocorticoid Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Electrolytes, Glomerular Filtration Rate, Humans, Renin-Angiotensin System, Risk, Randomized Controlled Trials as Topic, Treatment Outcome, Evidence-Based Medicine, Renal Insufficiency, Heart Failure, Systolic, Angiotensin Receptor Antagonists, Cardiac Resynchronization Therapy

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