What considerations should be made when treating heart failure and chronic kidney disease?
When treating heart failure and chronic kidney disease, there are a number of considerations that should be taken into account. Standard HFREF treatments should be considered for stage IIIb patients, however close monitoring is needed to help prevent hyperkalaemia and acute kidney injuries. In CKD stage IV, the side effects of all of these medications is likely to be increased, so standard HFREF treatment recommendations should generally be applied, subject to the consideration of individual risk factors and liaison with renal specialists as appropriate. Additionally, the cost of monitoring that is required in patients with both HFREF and CKD should be taken into account, as it could be offset by the savings of reducing the potential adverse effects of heart failure treatment on kidney function.