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Volume 14
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10.3390/jcm14238508
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Clinical Features and Outcomes of Patients with Heart Failure and Advanced Chronic Kidney Disease

by
María Anguita-Gámez
1,
Javier Herrera-Flores
2,
Juan L. Bonilla-Palomas
3,
Alejandro Recio-Mayoral
4,
Rafael González-Manzanares
2,
Juan C Castillo Domínguez
2,
José López-Aguilera
2,
Javier Muñiz
5,6 and
Manuel Anguita-Sánchez
2,6,*
1
Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain
2
UGC de Cardiología, Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
3
Unidad de Cardiología, Hospital San Juan de la Cruz, 23400 Úbeda, Spain
4
Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
5
Grupo de Investigación Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, 15006 A Coruña, Spain
6
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER CV), 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(23), 8508; https://doi.org/10.3390/jcm14238508 (registering DOI)
Submission received: 30 September 2025 / Revised: 22 November 2025 / Accepted: 29 November 2025 / Published: 30 November 2025
(This article belongs to the Section Nephrology & Urology)
Versions Notes

Abstract

Objectives: The aim was to evaluate the clinical features, management and 1-year outcomes in patients with heart failure (HF) and advanced chronic kidney disease (CKD) who were followed in specialized HF units in Spain. Methods: Data from the registry of the SEC-Excellent-HF quality program of the Spanish Society of Cardiology were analyzed. This registry included 1567 patients between 2019 and 2022 followed by 45 specialized HF units. Clinical features, treatment and 1-year rate of events (death and HF hospitalizations) were compared between the groups of advanced CKD (glomerular filtration rate <30 mL/minute/m2) and GFR ≥ 30 mL/min/m2. Results: 11.1% of patients had a GFR < 30 and 88.9% ≥ 30 mL/min/m2. The median LVEF was similar in groups with GFR < 30 and ≥ 30 mL/min/m2: 42% (IQR 30–58) versus 38% (IQR 29–54). Advanced CKD patients were older, had more severe HF (previous HF admissions in the last year, worse NYHA functional class and longer evolution time) and had higher prevalence of ischemic heart disease, diabetes mellitus, systemic hypertension, iron deficiency, anemia and hyponatremia. All drugs for HF, except for diuretics and potassium binders, were used in a lower proportion in patients with GFR < 30 mL/min/m2 (p < 0.001). One-year overall mortality (49.2 versus 13.7/100 patients-year; p < 0.001) and one-year HF hospitalizations rate (83.2 versus 30.7/100 patients-year; p < 0.001) were higher in the group of advanced CKD. Conclusions: In our study, patients with advanced CKD had different clinical characteristics, received indicated treatment in a lower proportion and had higher 1-year rates of death and HF admissions.
Keywords: heart failure; advanced chronic kidney renal disease; treatment; outcomes heart failure; advanced chronic kidney renal disease; treatment; outcomes

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MDPI and ACS Style

Anguita-Gámez, M.; Herrera-Flores, J.; Bonilla-Palomas, J.L.; Recio-Mayoral, A.; González-Manzanares, R.; Castillo Domínguez, J.C.; López-Aguilera, J.; Muñiz, J.; Anguita-Sánchez, M. Clinical Features and Outcomes of Patients with Heart Failure and Advanced Chronic Kidney Disease. J. Clin. Med. 2025, 14, 8508. https://doi.org/10.3390/jcm14238508

AMA Style

Anguita-Gámez M, Herrera-Flores J, Bonilla-Palomas JL, Recio-Mayoral A, González-Manzanares R, Castillo Domínguez JC, López-Aguilera J, Muñiz J, Anguita-Sánchez M. Clinical Features and Outcomes of Patients with Heart Failure and Advanced Chronic Kidney Disease. Journal of Clinical Medicine. 2025; 14(23):8508. https://doi.org/10.3390/jcm14238508

Chicago/Turabian Style

Anguita-Gámez, María, Javier Herrera-Flores, Juan L. Bonilla-Palomas, Alejandro Recio-Mayoral, Rafael González-Manzanares, Juan C Castillo Domínguez, José López-Aguilera, Javier Muñiz, and Manuel Anguita-Sánchez. 2025. "Clinical Features and Outcomes of Patients with Heart Failure and Advanced Chronic Kidney Disease" Journal of Clinical Medicine 14, no. 23: 8508. https://doi.org/10.3390/jcm14238508

APA Style

Anguita-Gámez, M., Herrera-Flores, J., Bonilla-Palomas, J. L., Recio-Mayoral, A., González-Manzanares, R., Castillo Domínguez, J. C., López-Aguilera, J., Muñiz, J., & Anguita-Sánchez, M. (2025). Clinical Features and Outcomes of Patients with Heart Failure and Advanced Chronic Kidney Disease. Journal of Clinical Medicine, 14(23), 8508. https://doi.org/10.3390/jcm14238508

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