Kidney Replacement Therapies in Advanced Heart Failure - Timing, Modalities, and Clinical Considerations

Ramzi Ibrahim; Chelsea Takamatsu; Abdulla Alabagi; Hoang Nhat Pham; Bijin Thajudeen; Sevag Demirjian; W H Wilson Tang; Preethi William

doi:10.1016/j.cardfail.2024.09.014

Kidney Replacement Therapies in Advanced Heart Failure - Timing, Modalities, and Clinical Considerations

J Card Fail. 2024 Oct 23:S1071-9164(24)00884-4. doi: 10.1016/j.cardfail.2024.09.014. Online ahead of print.

Authors

Ramzi Ibrahim¹, Chelsea Takamatsu², Abdulla Alabagi², Hoang Nhat Pham², Bijin Thajudeen³, Sevag Demirjian⁴, W H Wilson Tang⁵, Preethi William⁵

Affiliations

¹ Department of Medicine, University of Arizona, Tucson, Arizona. Electronic address: ramzi.ibrahim83@gmail.com.
² Department of Medicine, University of Arizona, Tucson, Arizona.
³ Division of Nephrology, University of Arizona, Tucson, Arizona.
⁴ Department of Kidney Medicine, Cleveland Clinic, Cleveland, Ohio.
⁵ Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.

PMID: 39454938
DOI: 10.1016/j.cardfail.2024.09.014

Abstract

Acute kidney dysfunction is commonly encountered in advanced heart failure and carries significant prognostic implications, often leading to poorer outcomes and increased mortality. It can alter the course of decision making for left ventricular assist device (LVAD) and cardiac transplantation candidacy. Kidney replacement therapies (KRT) offer a critical intervention in this context but require careful consideration of timing, various types of KRT modalities, individual patient preferences and circumstances. This review discusses the intricacies of KRT in advanced heart failure, examining how to optimize timing and choose among the various KRT modalities. It also provides a detailed discussion on the unique clinical scenarios that clinicians may face when treating this vulnerable patient group.

Keywords: Heart Failure; dialysis; kidney; renal.

Publication types

Review