What to do with foundation therapies for heart failure for patients with end-stage kidney disease on haemodialysis.
Br J Hosp Med (Lond)
; 85(4): 1-10, 2024 Apr 30.
Article
en En
| MEDLINE
| ID: mdl-38708982
ABSTRACT
There is a significant burden of cardiovascular disease morbidity and mortality in the end-stage kidney disease population, driven by traditional and non-traditional risk factors. Despite its prevalence, heart failure is difficult to diagnose in the dialysis population due to overlapping clinical presentations, limitations of investigations, and the impact on the cardiorenal axis. 'Foundation therapies' are the key medications which improve patient outcomes in heart failure with reduced ejection fraction and include beta-blockers, renin-angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter-2 inhibitors. They are underutilised in the dialysis population due to the exclusion of chronic kidney disease patients from major trials and legitimate clinical concerns e.g. hyperkalaemia, intradialytic hypotension and residual kidney function preservation. A coordinated cardiorenal multidisciplinary approach can guide appropriate diagnostic considerations (biomarkers interpretation, imaging, addressing unique complications of kidney disease), optimise dialysis management (prescription length, frequency and ultrafiltration targets) and when at euvolaemia facilitate the stepwise introduction of appropriate foundation therapies.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Diálisis Renal
/
Inhibidores del Cotransportador de Sodio-Glucosa 2
/
Insuficiencia Cardíaca
/
Fallo Renal Crónico
Límite:
Humans
Idioma:
En
Revista:
Br J Hosp Med (Lond)
Asunto de la revista:
HOSPITAIS
/
MEDICINA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido