Medical Management of Heart Failure With Reduced Ejection Fraction in Patients With Advanced Renal Disease.

Journal Article (Journal Article;Review)

Large randomized clinical trials (RCT) supporting guidelines for the management of heart failure with reduced ejection fraction (HFrEF) have typically excluded patients with advanced chronic kidney disease (CKD). Patients with concomitant advanced CKD and HFrEF experience poor cardiovascular outcomes and mortality relative to either disease in isolation and have been shown to consistently receive lower rates of HFrEF guideline-directed medical therapy (GDMT). This review evaluated recent evidence for the use of GDMT in patients with HFrEF and advanced CKD approaching dialysis from RCTs and observational cohorts. The authors also discuss the limitations and challenges inherent in the evidence for GDMT in this population, and offer guidance to clinicians for proper clinical use and future research directions.

Full Text

Duke Authors

Cited Authors

  • Hein, AM; Scialla, JJ; Edmonston, D; Cooper, LB; DeVore, AD; Mentz, RJ

Published Date

  • May 2019

Published In

Volume / Issue

  • 7 / 5

Start / End Page

  • 371 - 382

PubMed ID

  • 31047016

Pubmed Central ID

  • PMC6501813

Electronic International Standard Serial Number (EISSN)

  • 2213-1787

Digital Object Identifier (DOI)

  • 10.1016/j.jchf.2019.02.009


  • eng

Conference Location

  • United States