The European Society of Cardiology has published its first guidelines dedicated to the treatment of cardiovascular diseases together with chronic kidney disease, developed in collaboration with the European Renal Association. The recommendations were published in the European Heart Magazine and presented at the ESC 2026 Congress.
Chronic kidney disease (CKD) is diagnosed when abnormalities in kidney structure or function persist for at least 3 months and affect a person’s health. An estimated 100 million people across Europe suffer from CKD, and this condition substantially increases their risk of developing a variety of cardiovascular diseases (CVD).
The dangerous link between heart and kidney disease
“The disability and loss of life from each disease is profound, but CKD can accelerate cardiovascular disease and vice versa, resulting in cardiovascular events and the need for dialysis much earlier in life,” said working group chair Associate Professor Kevin Damman of the University Medical Center Groningen, the Netherlands. “The good news is that there have been important advances in recent years, meaning that there are now several simple treatments that can substantially reduce the risk of both cardiovascular and kidney complications.”
Because heart and kidney disease often occur together, the guidelines emphasize identifying kidney problems earlier in people already receiving treatment for cardiovascular disease.
Chair of the working group, Professor William Herrington from the University of Oxford, UK, said: “Many CKD patients are treated by the cardiology community and the new ESC guidelines aim to increase the use of kidney function and urine albumin testing in patients with CVD. With better detection, more patients at risk can be identified and the most appropriate treatments for both CKD and CVD can be prescribed.”
A new SEAL on the ERC strategy
To organize the recommendations, the Working Group created the acronym ‘STAMP on CKD’: Yesscreen, tmarriage, TOaddress the risk of CKD, METROmodify CVD management and Phealth services.
Detection is the first step. Guidelines recommend CKD testing for all CVD patients when cardiovascular disease is diagnosed. This involves blood and urine tests (glomerular filtration rate estimated from blood creatinine plus urine albumin-creatinine ratio).
Triage then focuses on determining the likelihood of a patient developing kidney failure, as well as assessing cardiovascular risk. The guidelines recommend the use of validated risk scoring tools that take kidney function into account.
Early treatment could reduce complications
The next priority is to address the risk by introducing proven, cost-effective therapies early enough to slow the progression of CKD and reduce the likelihood of cardiovascular events.
“Early use of drugs called RAS inhibitors and SGLT2 inhibitors along with statin-based therapy is particularly important and effective,” explained Associate Professor Damman.
The recommendations also identify situations in which cardiovascular treatment needs to be adjusted for people with CKD. Reduced kidney function can affect the body’s ability to eliminate certain medications, so the guidelines provide advice on what treatments can be used safely when standard options may not be appropriate.
Coordination of heart and kidney care
The final part of the strategy focuses on organizing health services so that patients at highest risk can be quickly recognized and receive timely care from both cardiologists and nephrologists.
“Active and efficient communication between specialties is often necessary due to the complexities associated with CKD,” Professor Herrington said. “Involving patients and their families/caregivers in the multidisciplinary care process also helps ensure that patients’ priorities are met, improve their experience, and promote patient-centered care.”
A patient version of the guidelines has also been developed to help people better understand their condition and participate more confidently in shared decisions with their healthcare providers.
The task force chairs concluded: “CVD and CKD are significant burdens for patients, healthcare systems and society. The key messages of these guidelines should be taken into account by all relevant healthcare stakeholders and policy makers, and research is planned to fill several gaps in the evidence. Raising awareness will help realize the hope that the guidelines will lead to significant individual and societal improvement for those with CVD and CKD or at risk of suffer them.”