Kidney Disease and Heart Failure: Recent Advances and Current Challenges

SGLT2 inhibitors, renin-angiotensin-aldosterone system inhibitors, finerenone and GLP-1 receptor agonists can benefit patients with heart failure (HF) and chronic kidney disease (CKD); evidence in advanced CKD remains limited

Small declines in kidney function after starting guideline-directed HF therapies generally do not require discontinuation (often hemodynamic, not associated with poor outcomes)

CKD-specific HF diagnostic thresholds and refined AKI definitions in HF are needed

Future CV and kidney trials should include end points such as kidney function trajectories, symptom burden and quality of life

A more integrated approach to management, rooted in individualization, clinical context and shared therapeutic goals, is needed