New medical guidelines issued by the European Society of Cardiology and the European Renal Association establish the first joint framework for managing cardiovascular disease alongside chronic kidney disease, a condition affecting an estimated 100 million Europeans. Published in the European Heart Journal, the recommendations target earlier screening, coordinated multidisciplinary care, and targeted drug therapies to lower the risk of heart attacks, strokes, and kidney failure.
The Dual Threat of Heart and Kidney Disease
Chronic kidney disease is formally diagnosed when abnormalities in kidney structure or function persist for at least three months. According to Task Force Chair Associate Professor Kevin Damman from the University Medical Centre Groningen in the Netherlands, the two conditions accelerate each other. “The disability and lifetime lost to each disease are profound, but CKD can accelerate CVD and vice versa, resulting in cardiovascular events and the need for dialysis much earlier in life,” Damman stated.
Did You Know? Approximately 100 million people across Europe live with chronic kidney disease, which substantially raises their lifetime risk of developing various cardiovascular complications.
Because these conditions frequently overlap, the guidelines urge clinicians to identify kidney issues much earlier in patients already receiving treatment for cardiovascular disease. Professor William Herrington of the University of Oxford noted that many patients with chronic kidney disease receive their primary care from cardiologists. The new framework aims to increase routine kidney function and urine albumin testing in this population to ensure patients receive appropriate treatments for both conditions simultaneously.
The STAMP on CKD Strategy
To streamline implementation, the Task Force introduced the “STAMP on CKD” acronym, guiding clinicians through five distinct operational phases:
- Screen: Test every patient diagnosed with cardiovascular disease for CKD using blood and urine measures, specifically the estimated glomerular filtration rate derived from blood creatinine and the urine albumin-to-creatinine ratio.
- Triage: Evaluate the likelihood of kidney failure and assess overall cardiovascular risk using validated risk-scoring tools.
- Address CKD Risk: Introduce cost-effective therapies early to slow disease progression.
- Modify CVD Management: Adjust cardiovascular medications safely, accounting for reduced kidney clearance.
- Plan Health Services: Coordinate specialized care across disciplines.
Pharmaceutical Interventions and Safety Adjustments
Implementing targeted treatments early remains a core priority of the new guidance. According to Associate Professor Damman, prescribing specific drug classes—namely RAS inhibitors and SGLT2 inhibitors alongside statin-based therapy—proves particularly effective at slowing kidney decline and preventing adverse cardiac events.
At the same time, the guidelines outline necessary adjustments to standard cardiovascular regimens. Reduced kidney function alters how the body clears pharmaceuticals, meaning clinicians must carefully verify which medications remain safe when standard options are no longer appropriate for patients with advanced chronic kidney disease.
Coordinating Care Across Specialties
Organizing healthcare services to connect high-risk patients with both cardiologists and nephrologists forms the final pillar of the strategy. Professor Herrington emphasized that active, efficient communication between specialties is often necessary due to the complexities associated with chronic kidney disease. The framework also incorporates patients and their caregivers into the multidisciplinary process to align treatment plans with personal priorities.
To support this shared decision-making process, the task force developed a dedicated patient version of the guidelines, helping individuals better understand their diagnoses and engage more confidently with their healthcare providers.
Frequently Asked Questions
What defines chronic kidney disease?
Chronic kidney disease is diagnosed when structural or functional abnormalities of the kidneys persist for at least three months and impact overall health.
What tests are recommended for cardiovascular patients?
The guidelines recommend testing every cardiovascular disease patient using blood tests for estimated glomerular filtration rate and urine tests for albumin-to-creatinine ratio.
Which medications are highlighted in the guidelines?
The recommendations emphasize the early use of RAS inhibitors, SGLT2 inhibitors, and statin-based therapies to lower both cardiovascular and kidney complication risks.
Who developed these new recommendations?
The guidelines were developed jointly by the European Society of Cardiology and the European Renal Association, and presented at the ESC Congress.