Furthermore, several renal factors have a direct impact on the heart and/or coronary microvasculature and may underlie the association between CKD and HFpEF. Macrovascular changes accompanying CKD, such as hypertension and arterial stiffening, have been described to contribute to HFpEF development. The typical co-existence of HFpEF and CKD is partially due to common underlying comorbidities, such as hypertension, dyslipidemia and diabetes. This is likely due to the multifactorial character and the lack of pathophysiological knowledge of HFpEF. In contrast, clinical trials for treatment of HFpEF have all shown negative or disputable results. Therapies for HFrEF are long established and considered quite successful.
Approximately, 50% of all patients with HF suffer from HFpEF, and this percentage is projected to rise in the coming years. Although studies have been performed on the association between CKD and HF with reduced ejection fraction (HFrEF), less is known about the link between CKD and heart failure with preserved ejection fraction (HFpEF). Heart failure (HF) and chronic kidney disease (CKD) co-exist, and it is estimated that about 50% of HF patients suffer from CKD.