What is the clinical and cost effectiveness of biomarker-based monitoring, monitoring with cardiac MRI, and monitoring with repeated echocardiography in people with heart failure who also have CKD?
The aim of this section of the review is to examine the clinical and cost-effectiveness of biomarker measurement or imaging in the management of heart failure in patients with CKD. Natriuretic peptides and troponin are raised in patients with HF and could potentially be used to guide treatment. However, renal function can affect the level of biomarkers in the blood principally by affecting their clearance and this effect could influence their interpretation of biomarker results by clinicians. Imaging with echocardiography or cardiac MRI could be an alternative method of monitoring.