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Diastolische Dysfunktion und HFpEF bei CKD: Ein Update [Diastolic dysfunction and HFpEF in CKD: An update]

Item Type:Review
Title:Diastolische Dysfunktion und HFpEF bei CKD: Ein Update [Diastolic dysfunction and HFpEF in CKD: An update]
Creators Name:Szijártó, I.A. and Wilck, N.
Abstract:Cardiac and renal (dys)functions are closely linked. Common risk factors lead to simultaneous or sequential loss of function of both organs, and derailed compensatory mechanisms promote progression to heart and renal failure. Approximately half of the heart failure patients have preserved left ventricular pump function (HFpEF). Although chronic kidney disease (CKD) is a risk factor for the development of HFpEF, there are major knowledge gaps in the pathogenesis of HFpEF. The treatment of HFpEF with the traditional heart failure methods does not improve the prognosis in this patient population. In addition, there is little evidence in patients with advanced CKD. Cornerstones of HFpEF treatment are prevention, optimal blood pressure control, physical activity, treatment of concomitant diseases and more recently, administration of sodium-glucose transporter 2 (SGLT2) inhibitors. Mineralocorticoid receptor antagonists (MRA) and angiotensin receptor neprilysin inhibitors (ARNI) are possible adjuncts to treatment. Numerous studies are underway that could fill the remaining knowledge gaps. This review provides an update on the pathogenesis, diagnostics, and treatment of HFpEF in CKD and highlights perspectives in the treatment and research.
Keywords:Chronic Renal Insufficiency, Heart Failure, Ejection Fraction, Diagnostics, Sodium-Glucose Transporter 2 Inhibitors
Page Range:361–369
Date:November 2023
Official Publication:https://doi.org/10.1007/s11560-023-00683-1

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