The Intertwined Pathophysiology of Heart and Kidney
The clinical management of heart failure (HF) is inextricably linked to renal function. In patients with heart failure with mildly reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF), the presence of chronic kidney disease (CKD) significantly complicates the therapeutic landscape and worsens prognosis. Traditionally, clinicians have relied on the estimated glomerular filtration rate (eGFR) to assess renal health, but contemporary evidence emphasizes that urine albumin-to-creatinine ratio (UACR) provides a complementary and equally vital dimension of kidney risk. The FINEARTS-HF trial, which investigated the non-steroidal mineralocorticoid receptor antagonist (MRA) finerenone, has provided a landmark dataset for understanding how these cardiorenal therapies perform across the spectrum of kidney health.
