Contemporary management of Heart Failure in association with renal outcomes and prognosis

Dear Colleagues,

Heart failure and, more so, the interplay with kidney disease, have been a challenging scientific conundrum in terms of management and outcomes for the last few decades. the definition of cardiorenal syndrome (CRS) includes a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in one organ may lead to acute or chronic dysfunction in the other, and despite numerous attempts to clearly define the different phenotypes, most commonly there is a significant overlap. Despite several advances over the years in the management of the two interrelated conditions, there are several remaining unmet targets and needs.

Most recently, the evolving field of heart failure management has been excitingly expanding with the introduction of new pharmacological and interventional management approaches. Pharmacological agents such as sodium-glucose co-transporter-2 (SGLT2) have been introduced and and its use is now well-established in clinical practice. Over the last months, the advent of a new pharmacological class has been warmly welcomed by the international cardiology scientific community. With primary indication another major disease, type 2 diabetes, SGLT2 inhibitors, were unexpecteldy shown to exert remarkable cardiovascular benefits, more so in association with heart failure morbidity and mortality. Most interestingly, these beneficial effects were independent of diabetes status or a glucose lowering effect but present in non-diabetic individuals, with mediating mechanisms still requiring further clarification. The same agents on the other hand, appear to exert equally impressive positive effects with regards to the progression of renal disease, which are again independent of their antidiabetic actions. This long-awaited landmark in the combined management of heart and renal disease, further highlights the underlying interrelation and the need for a unified approach to improve outcomes.

Dr. Emmanuel Androulakis and Dr. Eirini Lioudaki

Guest Editors

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