Cardio-renal interaction - Clinical trials update 2022

Nutr Metab Cardiovasc Dis. 2022 Nov;32(11):2451-2458. doi: 10.1016/j.numecd.2022.07.002. Epub 2022 Jul 19.

Abstract

Aims: Chronic kidney disease is a common cardiovascular risk indicator and strongly associated with increased morbidity and mortality. The heart and kidneys are pathophysiologically closely connected, which becomes particularly obvious in patients with cardiorenal syndrome. This review summarizes clinically relevant studies on the cardio-renal interaction published in 2021 and 2022.

Data synthesis: Selected trials published in high-impact journals were chosen from the database Pubmed and included in this review. New evidence about the selective mineralocorticoid receptor antagonist finerenone and the renoprotective sodium-glucose co-transporter-2-inhibitors (SGLT2-Inhibitors) are discussed and we update on novel insights about the treatment of arterial hypertension in patients with severe chronic kidney disease with the thiazide-like diuretic chlorthalidone. Finally, data on infective endocarditis in patients on chronic hemodialysis and the treatment of secondary hyperparathyroidism with the calcimimetic drug etelcalcetide in patients with end stage kidney disease are critically reviewed.

Conclusion: Several important studies investigating cardio-renal interactions were recently published may affect clinical practice. The graphical abstract (Fig. 1) depicts the most relevant clinical studies investigating cardio-renal interactions.

Keywords: Chlorthalidone; Chronic kidney disease; Endocarditis; Finerenone; Hemodialysis; SGLT2-inhibitor.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlorthalidone / therapeutic use
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucose
  • Humans
  • Kidney
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / drug therapy
  • Sodium
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors*
  • Thiazides / therapeutic use

Substances

  • Mineralocorticoid Receptor Antagonists
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • Thiazides
  • Sodium
  • Glucose
  • Chlorthalidone