CMHC Pulse Blog

Cardiovascular and renal health are undeniably linked—when one system is compromised, the other is often at risk. For healthcare providers, adopting an integrated, patient-centered approach is important for better outcomes. Here are our five top tips to help you stay aligned with the latest guidelines and improve cardiorenal care.

1. Embrace a Multidisciplinary Perspective 

Cardiorenal health isn’t just a focus area for cardiologists and nephrologists—it affects a wide range of specialties, including endocrinology and primary care. The heart and kidneys are closely connected, and issues in one often signal trouble in the other. Providers must acknowledge these overlaps and adopt a team-based approach to cardiorenal metabolic patient management. Collaborative care models enable the development of comprehensive treatment plans that address root causes and comorbidities, reducing cardiovascular and renal morbidity and mortality across diverse patient populations. 

2. Use Comprehensive Markers Beyond Traditional Measures 

Relying solely on traditional markers like eGFR and serum creatinine can limit early detection efforts. According to recent research, more sensitive indicators such as urinary albumin-to-creatinine ratios (UACR) should be part of routine screenings. Research shows that UACR is a powerful predictor of renal and cardiovascular risk. By using sensitive measures, providers can identify early kidney damage, potentially preventing further complications with timely interventions. 

3. Act Early: Proactive Screening and Intervention 

Early intervention can significantly reduce the risk of cardiorenal complications. Regular assessment of eGFR and UACR, particularly in high-risk populations such as those with diabetes or hypertension, provides crucial insights into patient health. Even small decreases in eGFR—less than 60 mL/min/1.73m²—are associated with an increased cardiovascular risk. Updated guidelines recommend using these markers to guide decisions on therapy, including statin use in patients with mildly reduced kidney function. 

4. Adopt Multi-Agent Therapy Approaches 

Guidelines increasingly support the use of multiple therapeutic agents to protect heart and kidney health. Key treatments now include SGLT2 inhibitors like empagliflozin and dapagliflozin, non-steroidal mineralocorticoid receptor antagonists (MRA) such as finerenone, and GLP-1 receptor agonists like semaglutide. Research stresses the use of these pillars of therapy, highlighting that combinations of these agents can significantly reduce the progression of chronic kidney disease (CKD) and lower cardiovascular risks. 

For instance, a recent simulation study using NHANES data showed comprehensive use of these therapies could prevent around 38,000 cardiovascular events in patients with early kidney disease.

5. Close the Treatment Gaps with Guideline-Directed Care 

Despite clear evidence supporting these treatments, gaps in implementation persist. Fewer than 50% of eligible patients are receiving recommended UACR screenings, and among those with a risk of progression and cardiovascular complications, only about 15% are receiving SGLT2 inhibitors. Even fewer are being prescribed non-steroidal MRAs. Providers must close these gaps and can start by applying current guidelines in clinical practice. Regular treatment plan reviews and patient education can increase the uptake of these practices. 

Key Takeaway: Integrated and Early Care Is Essential 

By adopting a proactive and integrated approach to managing cardiovascular and renal health, healthcare providers can significantly improve patient outcomes. Early detection through sensitive screening measures, comprehensive multi-agent therapies, and closing treatment gaps can mitigate risks and prevent the progression of chronic kidney disease and cardiovascular complications. 

For those seeking to deepen their expertise and stay current on the latest advances in cardiorenal care, the 19th Annual CMHC Conference On Demand is now open for pre-order.

Secure access to these sessions today to earn CME credits and incorporate the latest cardiorenal metabolic therapeutic insights into your practice.