Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.

Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, sharing significant overlap in prevalence and pathophysiological mechanisms. This coexistence, termed cardiorenal syndrome (CRS), often leads to anemia, which exacerbates both HF and CKD, thereby increasing morbidity and death....

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Detalles Bibliográficos
Autores: Vidas, MM, Portolés, J, Cobo, M, Gorriz, JL, Nuñez, J, Cases, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p19957
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/19957
Access Level:acceso abierto
Palabra clave:anemia treatment
cardiorenal syndrome
chronic kidney disease
heart failure
iron deficiency
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spelling Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.Vidas, MMPortolés, JCobo, MGorriz, JLNuñez, JCases, Aanemia treatmentcardiorenal syndromechronic kidney diseaseheart failureiron deficiencyHeart failure (HF) and chronic kidney disease (CKD) frequently coexist, sharing significant overlap in prevalence and pathophysiological mechanisms. This coexistence, termed cardiorenal syndrome (CRS), often leads to anemia, which exacerbates both HF and CKD, thereby increasing morbidity and death. Managing anemia in CRS is complex due to conflicting guidelines and the multifactorial nature of the condition. Anemia in CRS is influenced by factors such as inadequate erythropoietin production, iron deficiency, reduced red blood cell life span, and chronic inflammation, which inhibit iron absorption and mobilization. This interplay of mechanisms worsens anemia, further aggravating HF and CKD. Anemia significantly impacts the prognosis of both HF and CKD, and recent trials have shown that hemoglobin increases, particularly with sodium-glucose cotransporter 2 inhibitors, can improve outcomes in patients with HF and CKD. Iron deficiency is also prevalent in both patients with HF and patients with CKD and is associated with poorer exercise capacity and a higher mortality rate. Guidelines for diagnosing and treating iron deficiency differ between HF and CKD. Furthermore, treatment of anemia in CRS is controversial: While sodium-glucose cotransporter 2 inhibitors and intravenous iron has shown consistent benefits in patients with CRS, normalization of hemoglobin with erythropoiesis-stimulating agents improves symptoms and quality of life but have not consistently demonstrated cardiovascular benefits. There are no definitive guidelines for anemia management in CRS. Treatment should address HF, CKD, and anemia concurrently. A proposed algorithm includes correcting iron deficiency, initiating sodium-glucose cotransporter 2 inhibitors, and considering erythropoiesis-stimulating agents if hemoglobin remains <10 g/dL. Further research is needed to optimize anemia management strategies in patients with CRS.WILEY2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/19957Journal of the American Heart AssociationISSN: 20479980reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p199572026-06-07T16:35:31Z
dc.title.none.fl_str_mv Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
title Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
spellingShingle Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
Vidas, MM
anemia treatment
cardiorenal syndrome
chronic kidney disease
heart failure
iron deficiency
title_short Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
title_full Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
title_fullStr Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
title_full_unstemmed Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
title_sort Anemia Management in the Cardiorenal Patient: A Nephrological Perspective.
dc.creator.none.fl_str_mv Vidas, MM
Portolés, J
Cobo, M
Gorriz, JL
Nuñez, J
Cases, A
author Vidas, MM
author_facet Vidas, MM
Portolés, J
Cobo, M
Gorriz, JL
Nuñez, J
Cases, A
author_role author
author2 Portolés, J
Cobo, M
Gorriz, JL
Nuñez, J
Cases, A
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv anemia treatment
cardiorenal syndrome
chronic kidney disease
heart failure
iron deficiency
topic anemia treatment
cardiorenal syndrome
chronic kidney disease
heart failure
iron deficiency
description Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, sharing significant overlap in prevalence and pathophysiological mechanisms. This coexistence, termed cardiorenal syndrome (CRS), often leads to anemia, which exacerbates both HF and CKD, thereby increasing morbidity and death. Managing anemia in CRS is complex due to conflicting guidelines and the multifactorial nature of the condition. Anemia in CRS is influenced by factors such as inadequate erythropoietin production, iron deficiency, reduced red blood cell life span, and chronic inflammation, which inhibit iron absorption and mobilization. This interplay of mechanisms worsens anemia, further aggravating HF and CKD. Anemia significantly impacts the prognosis of both HF and CKD, and recent trials have shown that hemoglobin increases, particularly with sodium-glucose cotransporter 2 inhibitors, can improve outcomes in patients with HF and CKD. Iron deficiency is also prevalent in both patients with HF and patients with CKD and is associated with poorer exercise capacity and a higher mortality rate. Guidelines for diagnosing and treating iron deficiency differ between HF and CKD. Furthermore, treatment of anemia in CRS is controversial: While sodium-glucose cotransporter 2 inhibitors and intravenous iron has shown consistent benefits in patients with CRS, normalization of hemoglobin with erythropoiesis-stimulating agents improves symptoms and quality of life but have not consistently demonstrated cardiovascular benefits. There are no definitive guidelines for anemia management in CRS. Treatment should address HF, CKD, and anemia concurrently. A proposed algorithm includes correcting iron deficiency, initiating sodium-glucose cotransporter 2 inhibitors, and considering erythropoiesis-stimulating agents if hemoglobin remains <10 g/dL. Further research is needed to optimize anemia management strategies in patients with CRS.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/19957
url https://incliva.portalinvestigacion.com/publicaciones/19957
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv Journal of the American Heart Association
ISSN: 20479980
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
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