The impact of chronic kidney disease on medication choice and pharmacologic management in patients with heart failure.

INTRODUCTION: In the past few years, medical community, including doctors, have become increasingly aware of the fact that chronic kidney disease (CKD) and heart failure (HF) have common risk factors which impact one another in terms of choice of therapy. Areas covered: Management of these two diseases has been a challenge for physicians. The treatment goals for HF patients with CKD are very important. They serve as the end point in using a specific treatment for management and treatment of CKD patients, hence decreasing mortality rates. In this review, we discuss the pharmacological approaches to managing patients with HF and CKD, discussing current evidence-based up-to-date management strategies and guidelines in the general population with HF and CKD. Expert commentary: Newer novel drugs targeting specific signaling pathways are approaching the stages of clinical investigation including the direct renin inhibitors. They have been a highly attractive concept for the future in the management of these patients. However, while advances in technology elucidated many aspects of these diseases, many mysteries still remain. With continued research, we can expect more cost-effective and patient-friendly drug therapies to be developed in the near future.