title: Heart failure in patients with chronic kidney disease: a systematic integrative review.
abstract: BACKGROUND
  Heart failure (HF) is highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) and is strongly associated with mortality in these patients. However, the treatment of HF in this population is largely unclear.
  
  
  METHODS
  We conducted a systematic integrative review of the literature to assess the current evidence of HF treatment in CKD patients, searching electronic databases in April 2014. Synthesis used narrative methods.
  
  
  METHODS
  We focused on adults with a primary diagnosis of CKD and HF.
  
  
  METHODS
  We included studies of any design, quantitative or qualitative.
  
  
  METHODS
  HF treatment was defined as any formal means taken to improve the symptoms of HF and/or the heart structure and function abnormalities.
  
  
  RESULTS
  Measures of all kinds were considered of interest.
  
  
  RESULTS
  Of 1,439 results returned by database searches, 79 articles met inclusion criteria. A further 23 relevant articles were identified by hand searching.
  
  
  CONCLUSIONS
  Control of fluid overload, the use of beta-blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and optimization of dialysis appear to be the most important methods to treat HF in CKD and ESRD patients. Aldosterone antagonists and digitalis glycosides may additionally be considered; however, their use is associated with significant risks. The role of anemia correction, control of CKD-mineral and bone disorder, and cardiac resynchronization therapy are also discussed.
authors: Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Strada. Universităţii No. 16, 700115 Iaşi, Romania.
authors: Liviu
authors: L
authors: Segall
authors: Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Strada. Universităţii No. 16, 700115 Iaşi, Romania.
authors: Ionut
authors: I
authors: Nistor
authors: Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Strada. Universităţii No. 16, 700115 Iaşi, Romania.
authors: Adrian
authors: A
authors: Covic
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality / Q000473:pathology*; D012307:Risk Factors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors