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

被引：54
作者：
Hein, Aaron M. [1 ]
Scialla, Julia J. [1 ,2 ]
Edmonston, Daniel [1 ,2 ]
Cooper, Lauren B. [1 ,3 ]
DeVore, Adam D. [1 ,2 ]
Mentz, Robert J. [1 ,2 ]
机构：
[1] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA
[2] Duke Clin Res Inst, 2301 Erwin Rd,POB 17969, Durham, NC 27715 USA
[3] Inova Heart & Vasc Inst, Falls Church, VA USA
来源：
JACC-HEART FAILURE | 2019年 / 7卷 / 05期
基金：
美国国家卫生研究院;
关键词：
chronic kidney disease; heart failure management; heart failure with reduced ejection fraction; CHRONIC KIDNEY-DISEASE; VENTRICULAR SYSTOLIC DYSFUNCTION; CONVERTING ENZYME-INHIBITORS; SUDDEN CARDIAC DEATH; CARDIOVASCULAR-DISEASE; ASSOCIATION; HYPERKALEMIA; MORTALITY; OUTCOMES; SPIRONOLACTONE;
D O I：
10.1016/j.jchf.2019.02.009
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
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. (C) 2019 by the American College of Cardiology Foundation.
引用
收藏
页码：371 / 382
页数：12
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