The Intersection of Heart Failure with Preserved Ejection Fraction and CKD

Heart failure and CKD often coexist. Heart failure with preserved ejection fraction (HFpEF) contributes to significant morbidity and mortality among patients with CKD. Among patients with CKD, along with traditional risk factors for heart failure, numerous CKD-specific pathophysiologic pathways contribute to the heightened risk of HFpEF development. However, the heterogeneity of HFpEF presents numerous challenges for diagnosis, treatment, and prevention, which has led to various phenotyping approaches. Phenotyping HFpEF may allow for better HFpEF characterization for targeted management and development of risk stratification strategies for prevention. In this Kidney Cross-Talk article, we discuss the epidemiology of HFpEF in CKD, pathways of HFpEF development in CKD, and highlight the impact of CKD in HFpEF phenotyping. In addition, we propose a potential risk-based prevention algorithm for heart failure among patients with CKD.