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Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

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.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Damman K,Tang WH,Felker GM,Lassus J,Zannad F,Krum H,McMurray JJ

doi

10.1016/j.jacc.2013.11.031

subject

Has Abstract

pub_date

2014-03-11 00:00:00

pages

853-71

issue

9

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(13)06425-5

journal_volume

63

pub_type

杂志文章,评审

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