Research Advances in Heart Failure with Preserved Ejection Fraction Complicated by Chronic Kidney Disease

Corresponding author: LI JIE, lijie090715@126.com

DOI: 10.12201/bmr.202504.00077

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  Abstract: Heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD) are two chronic diseases with common risk factors and pathophysiological mechanisms. They interact with each other and significantly increase the risk of adverse cardiovascular and renal outcomes. Mechanisms such as sodium and water retention, neuroendocrine activation, chronic inflammation, anemia, oxidative stress, and excessive activation of the mineralocorticoid receptor jointly drive the vicious cycle of heart and kidney, leading to myocardial fibrosis, increased ventricular stiffness, and renal damage. In recent years, important progress has been made in the treatment strategies for HFpEF combined with CKD. In addition to traditional diuretics, drugs such as SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and GLP-1 receptor agonists have shown new therapeutic prospects. This article reviews the epidemiology, pathophysiological mechanisms, and the latest research progress in the treatment of HFpEF combined with CKD, aiming to enhance clinical understanding and management of this complex comorbidity.

  Key words: Heart failure; Heart failure with preserved ejection fraction; Chronic kidney disease; Cardiorenal syndrome; SGLT2 inhibitors; Review

  Submit time: 30 April 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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