Key result
Heart failure mortality is significantly increased in patients with baseline renal impairment, yet prognostic therapies remain underprescribed due to fears of worsening renal function.
Renal impairment is a critical prognostic factor in heart failure that is associated with increased mortality and highlights a significant gap in the prescription of guideline-directed medical therapies.
Patients with HF and renal impairment face higher mortality yet undertreatment; leaves open whether targeted GDMT strategies improve outcomes.
Heart failure mortality is significantly increased in patients with baseline renal impairment and those with underlying heart failure who subsequently develop renal dysfunction. This accelerated progression occurs independent of the cause or grade of renal dysfunction and baseline risk factors. Recent large prospective databases have highlighted the depth of the current problem, while longitudinal population studies support an increasing disease burden. We have extensively reviewed the epidemiological and therapeutic data among these patients. The evidence points to a progression of heart failure early in renal impairment, even in the albuminuric stage. The data also support poor prescription of prognostic therapies. As renal function is the most important prognostic factor in heart failure, it is important to establish the current understanding of the disease burden and the therapeutic implications.
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Iyngkaran et al. (2012) conducted a review in Comorbid Heart Failure and Renal Impairment. Prognostic heart failure therapies was evaluated. Heart failure mortality is significantly increased in patients with baseline renal impairment, yet prognostic therapies remain underprescribed due to fears of worsening renal function.
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