Burden and challenges of heart failure in patients with chronic kidney disease. A call to action

Nefrologia (Engl Ed). 2020 May-Jun;40(3):223-236. doi: 10.1016/j.nefro.2019.10.005. Epub 2019 Dec 31.
[Article in English, Spanish]


Patients with the dual burden of chronic kidney disease (CKD) and chronic congestive heart failure (HF) experience unacceptably high rates of symptom load, hospitalization, and mortality. Currently, concerted efforts to identify, prevent and treat HF in CKD patients are lacking at the institutional level, with emphasis still being placed on individual specialty views on this topic. The authors of this review paper endorse the need for a dedicated cardiorenal interdisciplinary team that includes nephrologists and renal nurses and jointly manages appropriate clinical interventions across the inpatient and outpatient settings. There is a critical need for guidelines and best clinical practice models from major cardiology and nephrology professional societies, as well as for research funding in both specialties to focus on the needs of future therapies for HF in CKD patients. The implementation of cross-specialty educational programs across all levels in cardiology and nephrology will help train future specialists and nurses who have the ability to diagnose, treat, and prevent HF in CKD patients in a precise, clinically effective, and cost-favorable manner.

Keywords: Cardiorenal medicine; Chronic kidney disease; Enfermedad renal crónica; Heart failure; Insuficiencia cardíaca; Medicina cardiorrenal.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities / organization & administration
  • Biomarkers
  • Cardiology / education
  • Cardiovascular Agents / therapeutic use
  • Combined Modality Therapy
  • Comorbidity
  • Curriculum
  • Disease Management
  • Disease Progression
  • Diuretics / therapeutic use
  • Education, Medical
  • Education, Nursing
  • Everolimus / adverse effects
  • Everolimus / therapeutic use
  • Health Services Needs and Demand*
  • Heart Diseases / diagnosis
  • Heart Diseases / diagnostic imaging
  • Heart Failure / economics
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Practice Guidelines as Topic
  • Prevalence
  • Prognosis
  • Renal Insufficiency, Chronic / economics
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / therapy
  • Renal Replacement Therapy / adverse effects
  • Renal Replacement Therapy / methods
  • Research
  • Self Care


  • Biomarkers
  • Cardiovascular Agents
  • Diuretics
  • Immunosuppressive Agents
  • Everolimus