# Ernstige nierfunctiestoornis verslechtert uitkomsten bij hartfalen — multi-centre cohort

*geplaatst 2026-10-19 · Nierziekte · Medicina clinica · doi 10.1016/j.medcli.2026.107658 · https://hartvaat.nl/2026/10/09/ernstige-nierfunctiestoornis-verslechtert-uitkomsten-bij-hartfalen-multi-centre-/*

In een multi-centre cohort van 2.245 hartfalenpatiënten vergeleken onderzoekers de 1-jaarsuitkomsten en behandelingspatronen tussen HFrEF, HFmrEF en HFpEF, gesplitst naar nierfunctiestadium (1-3 versus 4-5). Patiënten met een ernstige nierfunctiestoornis (CKD 4-5) kregen significant minder vaak ARNI, MRA, bètablokkers en SGLT2-remmers en hadden een hoger risico op overlijden en hartfalenheropname, met name bij HFrEF. Bij milde nierfunctiestoornis waren er geen verschillen tussen de hartfaaltypen. De bevindingen benadrukken de behandelachterstand bij nierinsufficiëntie en de noodzaak van intensievere cardiorenale zorg en optimale medicatie-adaptatie in deze kwetsbare groep.

## English: One-year outcomes in patients with heart failure and chronic kidney disease: differences according to the type of heart failure and kidney disease stages.

A multicentre cohort of 2,245 heart failure patients was analysed to compare one-year mortality and hospitalisation rates across HFrEF, HFmrEF and HFpEF subtypes, stratified by chronic kidney disease stage (1–3 vs 4–5). Patients with advanced CKD received significantly less guideline-directed medical therapy (ARNI, MRA, beta-blockers, SGLT2 inhibitors) and experienced higher event rates, particularly in HFrEF, whereas no subtype differences emerged in the mild CKD group. The data highlight a persistent treatment gap in cardiorenal patients and underscore the need for proactive medication optimisation and tailored follow-up in those with severe renal impairment.

## Abstract (original, from the publication)

AIMS: To analyze the differences in clinical characteristics, treatment and 1-year outcomes between patients with HFrEF, HFmrEF and HFpEF according to CKD stage (4-5 versus 1-3). METHODS: We analyzed data from 2,245 patients with HF included between 2019 and 2024 by 68 specialized HF units. Clinical characteristics, treatment and 1-year mortality and HF hospitalization rates were compared in HFrEF, HFmrEF and HFpEF patients according to CKD stages4-5 versus 1-3. RESULTS: Of the 2,245 patients, 54.2% were HFrEF, 12% HFmrEF and 33.8% HFpEF. CKD stages4-5 were present in 9.9% (8.9% of HFrEF, 11.5% of HFmrEF and 11.3% of HFpEF patients). Median age was 73years (IQR: 63-80), being older in CKD 4-5 stages, and 37.3% were female. CKD 4-5 patients received in significantly lower proportion ARNI, MRA, betablockers and SGLT2i in HFrEF and HFmrEF. One-year mortality and 1-year rate of HF hospitalizations were significantly higher in patients with HFrEF and lower in those with HFmrEF and HFpEF in cases of CKD 4-5, but there were no differences among the three types of HF in the CKD 1-3 subgroup. There was significant interaction between ERC severity and HF subtypes (P=.025 for mortality and P=.046 for HF hospitalizations). CONCLUSIONS: In this contemporary cohort of patients with HF, an association between renal dysfunction and type of HF was observed in terms of 1-year outcomes, with significant differences in event rates between HF types only in cases of more severe CKD.

Auteurs: María Anguita-Gámez, Rafael González-Manzanares, Juan L Bonilla-Palomas, Alberto Esteban-Fernández, Alejandro Recio-Mayoral, Javier Muñiz, Martín Ruiz-Ortiz, Manuel Crespin-Crespín, Manuel Anguita-Sánchez, Dolores Mesa-Rubio

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Bron: Medicina clinica, https://doi.org/10.1016/j.medcli.2026.107658. Bijgewerkt 2026-10-12T01:28:44Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.