Heart disease and kidney disease can fuel each other. New guidelines aim to break the cycle

The European Society of Cardiology has introduced guidelines aimed at addressing the intertwined risks of heart disease (cardiovascular disease, CVD) and chronic kidney disease (CKD). These recommendations, published in the European Heart Journal and discussed at ESC Congress 2026, highlight that CKD can speed up the onset of CVD and vice versa, leading to complications and a need for dialysis at a younger age.

According to the Task Force Chair, Associate Professor Kevin Damman from University Medical Centre Groningen, Netherlands, CKD and CVD have profound impacts on a person's health and quality of life. However, recent medical advancements have resulted in several simple treatments that can significantly reduce the risk of both conditions. The guidelines stress the importance of identifying kidney issues earlier in patients with existing cardiovascular disease.

Professor William Herrington from the University of Oxford emphasized that many CKD patients are treated by cardiologists. The new ESC Guidelines aim to boost the use of kidney function and urine albumin testing in individuals with CVD. By improving screening, healthcare providers can identify at-risk patients and prescribe the most suitable treatments for both CKD and CVD.

The guidelines summarize their recommendations using the STAMP on CKD acronym: Screen, Triage, Address CKD Risk, Modify CVD management, and Plan health services. Screening is the first step, recommending testing every patient with CVD for CKD upon diagnosis. This involves blood and urine tests, like estimating glomerular filtration rate from blood creatinine and urine albumin-to-creatinine ratio.

Triage focuses on determining the likelihood of kidney failure and evaluating cardiovascular risk, using validated risk scoring tools that consider kidney function. Addressing risk involves early introduction of cost-effective therapies like RAS inhibitors and SGLT2 inhibitors alongside statin-based therapy.

The guidelines also address situations where cardiovascular treatment needs adjustment for CKD patients. Reduced kidney function can affect the body's ability to clear certain medicines, so the recommendations provide advice on safe treatment options in such cases. Lastly, the guidelines focus on organizing healthcare services to quickly recognize high-risk patients and provide timely care from both cardiologists and nephrologists.

Active communication between specialties and patient engagement in the multidisciplinary care process are also crucial for effective care.