Congestive heart failure in chronic kidney disease: Disease-specific mechanisms of systolic and diastolic heart failure and management

There is a high prevalence of cardiovascular disease (CVD) in chronic kidney disease (CKD), and the incidence of congestive heart failure is substantially higher than in the general population. Staging CKD by glomerular filtration rate is important, particularly because the prevalence of CVD increases as CKD deteriorates. Risk factors for CKD and CVD overlap but may change as both diseases progress. Management options for improving symptoms, morbidity, hospitalizations, and mortality are available, although the evidence base that supports them is not optimal. Distinctive aspects of CKD patients sometimes warrant special consideration in making management decisions.