# Hartfalen en chronisch nierfalen vertonen de snelste overlevingsdaling bij cardio-renaal-metabool syndroom

*geplaatst 2026-10-17 · Nierziekte · European journal of heart failure · doi 10.1093/ejhf/xuag308 · https://hartvaat.nl/2026/10/09/hartfalen-en-chronisch-nierfalen-vertonen-de-snelste-overlevingsdaling-bij-cardi/*

De CaReMap-cohortstudie onderzocht bij 71.694 volwassenen met diabetes, hartfalen of chronisch nierfalen hoe deze aandoeningen samen verlopen en welke overlevingskansen bestaan. Bij patiënten met een nieuwe diagnose was hartfalen het sterkst geassocieerd met het ontwikkelen van een bijkomende aandoening (60,4% na 6 jaar), terwijl nierfalen het hoogste risico op overlijden vóór een nieuwe diagnose gaf (43,3% na 6 jaar). Deze real-world data benadrukken het hoge sterfterisico en de complexe ziekteprogressie bij cardio-renaal-metabool syndroom, wat klinici kan helpen bij risicostratificatie en het inrichten van geïntegreerde zorgpaden.

## English: Clinical trajectory and disease progression in patients with cardio-renal-metabolic syndrome: the CaReMap observational study.

The CaReMap observational study tracked disease trajectories and survival in 71,694 adults with diabetes, heart failure, or chronic kidney disease. Heart failure carried the highest risk of developing an additional condition (60.4% at 6 years), while chronic kidney disease presented the highest competing risk of death before a new diagnosis (43.3% at 6 years). These real-world findings highlight the steep survival decline and complex interplay in cardio-renal-metabolic syndrome, offering clinicians valuable data for risk stratification and integrated care planning.

## Abstract (original, from the publication)

BACKGROUND: Cardio-renal-metabolic (CRM) syndrome describes the pathophysiological interconnection among diabetes mellitus (DM), atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF), and chronic kidney disease (CKD). Limited studies simultaneously examine progression trajectories across all three conditions at the population level. We aimed to quantify the coexistence of CRM components, with a specific focus on patients with HF, and analyse survival and disease progression in a real-world setting. METHODS: CaReMap, an observational cohort study, analysed data from an Italian Regional Epidemiological Repository. The selection period spanned from 2017 to 2022. Incident patients had a first diagnosis of DM, HF, or CKD after January 1, 2017. Prevalent patients were classified based on their baseline morbidity status on January 1, 2017. Descriptive statistics, Kaplan-Meier survival estimates, and cumulative incidence curves for cause-specific events were reported. The CRM stage was further defined according to disease coexistence and severity. RESULTS: CaReMap included 71,694 adults with established CRM-related conditions (31.8% incident; 68.2% prevalent). Among incident patients, HF was associated with the highest probability of developing an additional diagnosis (60.4% at 6 years), while CKD showed the highest probability of death before a new diagnosis (43.3% at 6 years). In prevalent patients, the DM&HF group showed the highest cumulative incidence of further diagnoses (47.1% at 6 years). Across both incident and prevalent cohorts, HF and CKD patients experienced the steepest decline in overall survival. CONCLUSION: In this population-based Italian cohort, DM, HF, and CKD define distinct diagnostic trajectories with substantial competing risk of death. These findings provide real-world estimates of transition patterns and absolute risks that may inform risk stratification and integrated care pathways.

Auteurs: Federico Turoldo, Giulia Barbati, Cinzia Radesich, Vittorio Di Maso, Riccardo Candido, Manuela Bosco, Arjuna Scagnetto, Simona Barzaghi, Serena Falato, Carla Scognamillo, Andrea di Lenarda

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Bron: European journal of heart failure, https://doi.org/10.1093/ejhf/xuag308. Bijgewerkt 2026-10-10T01:19:23Z. 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.