The heart and the kidney share immense metabolic demands, overlapping stressors, and devastating diseases. Cardiovascular disease remains the predominant cause of death for people with kidney diseases. In turn, the development of chronic kidney disease portends poor outcomes and may limit guideline-directed medical therapies for people with cardiovascular disease.
Thankfully, kidney and cardiovascular diseases are also joined by a growing number of therapeutic options: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (alone or in combination with neprilysin inhibitors), glucagon-like peptide 1 receptor agonists, mineralocorticoid receptor antagonists, and of course, sodium-glucose cotransporter-2 inhibitors. Nephrologists and cardiologists now welcome our shared patients to the kitchen of many cooks. However, the need for dedicated cardio-nephrologists rises with the growing complexities of advanced heart failure management, cardiothoracic surgery, and other cardiovascular disease treatments.
In this special issue of Kidney News, we explore cardiorenal topics for the nephrologist that range from the common (e.g., loop diuretic choice in heart failure) to the critical (e.g., combined kidney-heart transplant and complications of left ventricular assist devices). We also highlight the experience of model cardio-nephrology clinical and training centers across the United States.