Cardiovascular risk and chronic kidney disease: strategies for cardiac and renal protection. Interdisciplinary consensus

The consensus was developed by experts from the Russian Scientific Medical Society of Internal Medicine, the Russian Society for the Prevention of Noncommunicable Diseases, the National Nephrology Association, the Professional Nephrology Association, the Russian Society of Cardiology, the Russian Medical Society for Arterial Hypertension, the Heart Failure Society, the National Atherosclerosis Society, the Russian Endocrinology Association, and the Russian Gerontology and Geriatrics Association.

The expert consensus opinion was compiled on the basis of the relevant sections of national and international clinical guidelines on chronic kidney disease, prevention and treatment of atherosclerosis, hypertension, diabetes and heart failure.

1. Functional state of the kidneys and prediction of cardiovascular risk. VNOK and NONP recommendations. Cardiovascular therapy and prevention. 2008;7(6 S3):1-20. (In Russ.) EDN WATIVJ.

2. Moiseev VS, Mukhin NA, Smirnov AV, et al. Cardiovascular risk and chronic kidney disease: strategies for cardio-nephro-protection. Russian Journal of Cardiology. 2014;(8):7-37. (In Russ.) doi:10.15829/1560-4071-2014-8-7-37.

3. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. GBD Chronic Kidney Disease Collaboration. Lancet. 2020;395:709-33. doi:10.1016/S0140-6736(20)30045-3.

4. Francis A, Harhay MN, Ong ACM, et al.; American Society of Neph­rology; European Renal Association; International Society of Nephrology. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;3. doi:10.1038/s41581-024-00820-6.

5. National Kidney Foundation. K/DOQI Clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):SI-266.

6. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluaion and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018.

7. Tkacheva ON, Kotovskaya YuV, Bobkova IN, et al. Chronic kidney disease in elderly and senile patients. The agreed opinion of experts of the Russian Association of Gerontologists and Geriatricians, the Scientific Society of Nephrologists of Russia and the Eurasian Association of Therapists. Russian Journal of Geriatric Medicine. 2024;(1):6-20. (In Russ.) doi:10.37586/2686-8636-1-2024-6-20.

8. Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication — worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant. 2019;34:1803-5.

9. Bello AK, Okpechi IG, Levin A, et al.; and the ISN-GKHA Group. An update on the global disparities in kidney disease burden and care across world countries and regions. Lancet Glob Health. 2024;12:e382-95.

10. Sozio SM, Pivert KA, Caskey FJ, Levin A. The state of the global nephrology workforce: a joint ASN-ERA-EDTA-ISN investigation. Kidney International. 2021;100:995-1000. doi:10.1016/j.kint.2021.07.029.

11. Ortiz A, Wanner C, Gansevoort R, ERA Council. Chronic kidney disease as cardiovascular risk factor in routine clinical practice: a position statement by the Council of the European Renal Association. European Journal of Preventive Cardiology. 2022; 29:2211-5. doi:10.1093/eurjpc/zwac186.

12. Smirnov AB, Kayukov IG, Yesayan AM, et al. Preventive approach in modern nephrology. Nephrology. 2004;8(3):7-14. (In Russ.) doi:10.24884/1561-6274-2004-8-3-7-14.

13. Smirnov AB, Dobronravov VA, Kayukov IG, et al. Epidemiology and socio-economic aspects of chronic kidney disease. Nephrology. 2006;10(1):7-13. (In Russ.)

14. Oshchepkova EV, Dolgusheva YuA, Zhernakova YuV, et al. The prevalence of renal dysfunction in arterial hypertension (according to the epidemiological study of ESSE-RF). Systemic hypertension. 2015;12(3):19-24. (In Russ.)

15. Boytsov SA, Drapkina OM, Shlyakhto EV, et al. The ESSE-RF study (Epidemiology of cardiovascular diseases and their risk factors in the regions of the Russian Federation). Ten years later. Cardiovascular Therapy and Prevention. 2021;20(5):3007. (In Russ.) doi:10.15829/1728-8800-2021-3007.

16. Kobalava JD, Villevalde SV, Borovkova NYu, et al. On behalf of the CHRONOGRAPH program researchers. Prevalence of markers of chronic kidney disease in patients with arterial hypertension: results of an epidemiological study CHRONOGRAPH. Cardiologiia. 2017;57(10):39-44. (In Russ.) doi:10.18087/cardio.2017.10.10041.

17. Kobalava JD, Villevalde SV, Bagmanova NH, et al. Prevalence of markers of chronic kidney disease in patients with arterial hypertension depending on the presence of diabetes mellitus: results of an epidemiological study CHRONOGRAPH. Russian Journal of Cardiology. 2018;(2):91-101. (In Russ.) doi:10.15829/1560-4071-2018-2-91-101.

18. Dedov II, Shestakova MV, Vikulova OK, et al. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010-2022. Diabetes mellitus. 2023;26(2):104-23. (In Russ.) doi:10.14341/DM13035.

19. Shlyakhto EV, Belenkov YuN, Boytsov SA, et al. Results of an interim analysis of a prospective observational multicenter registry study of patients with chronic heart failure in the Russian Federation "PRIORITY-CHF": initial characteristics and treatment of the first included patients. Russian Journal of Cardiology. 2023;28(10):5593. (In Russ.) doi:10.15829/1560-4071-2023-5593.

20. Andrusev AM, Tomilina NA, Peregudova NG, Shinkarev MB. Sub­stitution therapy for terminal chronic renal failure in the Russian Federation 2014-2018. A report based on the data of the All-Russian register of renal replacement therapy of the Russian Di­alysis Society. Nephrology and dialysis. 2020;22(S1):1-71. (In Russ.)

21. Prikhodina L, Komissarov K, Bulanov N, et al.; Regional Board and ISN-GKHA Team Authors. Capacity for the management of kidney failure in the International Society of Nephrology Newly Independent States and Russia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA). Kidney Int Suppl (2011). 2024;13(1):71-82. doi:10.1016/j.kisu.2024.01.005.

22. Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2020;75(1 Suppl 1): A6-A7. doi:10.1053/j.ajkd.2019.09.003.

23. McCullough KP, Morgenstern H, Saran R, et al. Projecting ESRD Incidence and Prevalence in the United States through 2030. J Am Soc Nephrol. 2019;30:127-35. doi:10.1681/ASN.2018050531.

24. Matsushita K, van der Velde M, Astor BC, et al. Chronic Kidney Di­sease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a col­laborative meta-analysis. Lancet. 2010;375(9731):2073-81.

25. Levey AS, de Jong PE, Coresh J, et al. The definition, clas­si­fi­cation, and prognosis of chronic kidney disease: a KDIG0 Controversies Conference report. Kidney int. 2011;80(l):17-28. doi:10.1038/ki.2010.483.

26. Foley R, Murray A, Li S, et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am SocNephrol. 2005;16:489-95.

27. Wu B, Bell K, Stanford A, et al. Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns — NHANES 2007-2012. BMJ Open Diabetes Research and Care. 2016;4:e000154. doi:10.1136/bmjdrc-2015-000154.

28. Visseren FLJ, Mach F, Smulders YM, et al.; ESC Scientific Do­cument Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). European Heart Journal. 2021;42(34):3227-337.

29. Levey AS, Stevens LA, Schmid CH, et al. A new equation to es­ti­mate glomerular filtration rate. Ann Intern Med. 2009;150:604-12.

30. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for Di­abe­tes Management in Chronic Kidney Disease. Kidney Int. 2020; 98(4S):S1-S115.

31. Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Diabetes Care. 2014;37(10):2864-83. doi:10.2337/dc14-1296.

32. Fox CS, Matsushita K, Woodward M, et al. Associations of kidney di­sease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012;380(9854):1662-73. doi:10.1016/S0140-6736(12)61350-6.

33. Algorithms of specialized medical care for patients with diabetes mellitus. Edited by I. I. Dedov, M. V. Shestakova, O. Yu. Sykhareva. 12th issue. Moscow; 2025. p. 248. (In Russ.)

34. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021;99(3S):S1-S87.

35. Böhm M, Thoenes M, Danchin N, et al. Association of cardiovascular risk factors with microalbuminuria in hypertensive individuals: the i-SEARCH global study. J Hypertens. 2007;25(11):2317-24.

36. Wright JT Jr, Williamson JD, Whelton PK, et al. SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103-16. doi:10.1056/NEJMoa1511939.

37. Lopez R, Copeland T, McCulloch C, et al. Additive effects of in­ten­sive BP control and ACE inhibition on suppression of proteinuria in patients with CKD. JHumHypertens. 2023;37(5):419-21. doi:10.1038/s41371-023-00823-z.

38. Kobalava JD, Konradi AO, Nedogoda SV, et al. Arterial hyper­ten­sion in adults. Clinical guidelines 2024. Russian Journal of Car­diology. 2024;29(9):6117. (In Russ.) doi:10.15829/ 1560-4071-2024-6117.

39. Ezhov MV, Kukharchuk VV, Sergienko IV, et al. Disorders of li­pid metabolism. Clinical Guidelines 2023. Russian Journal of Car­diology. 2023;28(5):5471. (In Russ.) doi:10.15829/1560-4071-2023-5471.

40. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296-305.

41. Manjunath G, Tighiouart H, Ibrahim H, et al. Level of kidney func­tion as a risk factor for atherosclerotic cardiovascular outcomes in the community. J Am CollCardiol. 2003;41(1):47-55.

42. Matsushita K, Ballew SH, Wang AY, et al. Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. Nat Rev Nephrol. 2022;18(11):696-707. doi:10.1038/s41581-022-00616-6.

43. Matsushita K, Coresh J, Sang Y, et al. Estimated glomerular filtra­tion rate and albuminuria for prediction of cardiovascular out­comes: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. 2015;3(7):514-25. doi:10.1016/S2213-8587(15)00040-6.

44. Mielniczuk LM, Pfeffer MA, Lewis EF, et al. Estimated glomerular filtration rate, inflammation, and cardiovascular events after an acute coronary syndrome. Am Heart J. 2008;155:725-31.

45. Gibson CM, Dumaine RL, Gelfand EV, et al. Association of glomerular filtration rate on presentation with subsequent mortality in non-ST-segment elevation acute coronary syndrome: Observations in 13,307 patients in five TIMI trials. Eur Heart J. 2004; 25(22):1998-2005.

46. Anavekar NS, McMurray JJ, Velazquez EJ, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285-95.

47. Panchal HB, Zheng S, Devani K, et al. Impact of chronic kidney disease on revascularization and outcomes in patients with ST-elevation myocardial infarction. Am J Cardiol. 2021;150:15-23. doi:10.1016/j.amjcard.2021.03.057.

48. Santopinto JJ, Fox KA, Goldberg RJ, et al. Creatinine clearance and adverse hospital outcomes in patients with acute coronary syndromes: findings from the global registry of acute coronary events (GRACE). Heart. 2003;89:1003-8.

49. Junho CVC, Frisch J, Soppert J, et al. Cardiomyopathy in chronic kid­ney disease: clinical features, biomarkers and the contribution of murine models in understanding pathophysiology. Clin Kid­ney J. 2023;16(11):1786-803. doi:10.1093/ckj/sfad085.

50. Grams ME, Coresh J, Matsushita K, et al. Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes. An Individual-Participant Data Meta-Analysis. JAMA. 2023;330(13):1266-77. doi:10.1001/jama.2023.17002.

51. Collins AJ, Vassalotti JA, Wang C, et al. Who should be targeted for CKD screening? Impact of diabetes, hypertension, and cardiovascular disease. Am J Kidney Dis. 2009;53 (Suppl 3):71-7.

52. Herzog C. Kidney disease in cardiology. Nephrol Dial Transplant. 2008;23(8):42-6.

53. Clase CM, Garg AX, Kiberd BA. Prevalence of low glomerular fil­tration rate in nondiabetic Americans: Third National Health and Nut­rition Examination Survey (NHANES III). J Am SocNephrol. 2002;13(5):1338-49.

54. Nitsch D, Grams M, Sang Y, et al.; Chronic Kidney Disease Prognosis Consortium. Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a me­ta-analysis. BMJ. 2013;346:f324. doi:10.1136/bmj.f324.

55. Claudel SE, Waikar SS, Schmidt IM, et al. The relationship bet­ween low levels of albuminuria and mortality among adults with­out major cardiovascular risk factors. Eur J Prev Cardiol. 2024; 31(17):2046-55. doi:10.1093/eurjpc/zwae189.

56. Claudel SE, Verma A. Albuminuria in Cardiovascular, Kidney, and Metabolic Disorders: A State-of-the-Art Review. Circulation. 2025;151(10):716-32. doi:10.1161/CIRCULATIONAHA.124.071079.

57. McDonagh TA, Metra M, Adamo M, et al. ESC Scientific Do­cu­ment Group. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treat­ment of acute and chronic heart failure of the European So­ciety of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2023;44(37): 3627-39. doi:10.1093/eurheartj/ehad195.

58. Marcos MC, Espriella R, Ordás JG, et al. Prevalence and clinical profile of kidney disease in patients with chronic heart failure. Insights from the Spanish cardiorenal registry. Revista Española de Cardiología (English Edition). 2024;77,1:50-9.

59. Kottgen A, Russell SD, Loehr LR, et al. Reduced kidney function as a risk factor for incident heart failure: the atherosclerosis risk in communities (ARIC) study. J Am SocNephrol. 2007;18:1307-15. doi:10.1681/ASN.2006101159.

60. Parmar SS, Muthuppalaniappan V, Debasish B. Gaps in Modern Heart Failure and Chronic Kidney Disease Research, European Cardiology Review. 2023;18:e51. doi:10.15420/ecr.2022.64.

61. Ronco C, McCullough P, Anker S, et al. Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative. Eur Heart J. 2010;31:703-11.

62. Zhang J, Hu Z, Tan Y, Ye J. Causal relationship from heart fai­lure to kidney function and CKD: A bidirectional two-sample mende­lian randomization study. PLoS ONE. 2023;18(12):e0295532. doi:10.1371/journal.pone.0295532.

63. Zoccali C, Mallamaci F, Adamczak M, et al. Cardiovascular com­plications in chronic kidney disease: a review from the Euro­pean Renal and Cardiovascular Medicine Working Group of the European Renal Association. Cardiovasc Res. 2023;119(11): 2017-32. doi:10.1093/cvr/cvad083.

64. Löfman I, Szummer K, Evans M, et al. Incidence of, Associations With and Prognostic Impact of Worsening Renal Function in Heart Failure With Different Ejection Fraction Categories. Am. J. Cardiol. 2019;124:1575-83.

65. Heywood JT, Fonarow GC, Costanzo MR, et al.; Committee ASA Investigators (2007). High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database. J Card Fail. 2007;13:422-30. doi:10.1016/j.cardfail.2007.03.011.

66. Hillege HL, Nitsch D, Pfeffer MA, et al. Renal function as a pre­dictor of outcome in a broad spectrum of patients with heart failure. Circulation. 2006;113:671-8. doi:10.1161/CIRCULATIONAHA.105.580506.

67. Patel RB, Fonarow GC, Greene SJ, et al. Kidney function and out­comes in patients hospitalized with heart failure. JAmCollCardiol. 2021;78:330-43.

68. Mezhonov EM, Reitblat OM, Vyatkina YuA, et al. Chronic kid­ney disease and chronic heart failure: impact on prognosis and choice of pathogenetic therapy. Therapeutic Archive. 2024;96(7): 666-74. (In Russ.) doi:10.26442/00403660.2024.07.202781.

69. Wilson P, D’Agostino Rb, Parise H, et al. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066-72.

70. Kobalava JD, Moiseev VS. The concept of cardiorenal and metabolic relationships in modern preventive cardiology. Cardiovascular therapy and prevention. 2008;7(4):4-7. (In Russ.)

71. Mukhin NA, Balkarov IM, Moiseev VS, et al. Chronic progressive neph­ropathies and the lifestyle of modern man. Therapeutic archive. 2004;(9):5-10. (In Russ.)

72. Kobalava JD, Kotovskaya YV, Tolkacheva VV, Milto AS. Uric acid is a key component of the cardiorenometabolic continuum. Car­diovascular therapy and prevention. 2008;7(4):95-100. (In Russ.)

73. Desai RJ, Franklin JM, Spoendlin-Allen J, et al. An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout. PLoS One. 2018;13(2):e0193622. Published online 2018. doi:10.1371/journal.pone.0193622.

74. Despres J-P. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J. 2006;8(suppl. B):4-12.

75. Pommer W. Preventive Nephrology: The Role of Obesity in Dif­ferent Stages of Chronic Kidney Disease. Kidney Dis. 2018;4:199-204. doi:10.1159/000490247.

76. Ndumele CE, Rangaswami J, Chow SL, et al.; on behalf of the American Heart Association. Cardiovascular-kidney-me­tabolic health: a presidential advisory from the American Heart Association. Circulation. 2023;148:1606-35. doi:10.1161/CIR.0000000000001184.

77. Sebastian SA, Padda I, Johal G. Cardiovascular-Kidney-Metabo­lic (CKM) syndrome: A state-of-the-art review. CurrProblCardiol. 2024;49(2):102344. doi:10.1016/j.cpcardiol.2023.102344.

78. Roghi A, Savonitto S, Cavallini C, et al. Impact of acute renal failure following percutaneous coronary intervention on long-term mortality. J Cardiovasc Med. 2008;9:375-81.

79. Bagshaw SM, Lapinsky S, Dial S, et al. Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy. Intensive Care Med. 2009;35:871-81.

80. Latchamsetty R, Fang J, Kline-Rogers E, et al. Prognostic value of transient and sustained increase in in-hospital creatinine on outcomes of patients admitted with acute coronary syndrome. Am J Cardiol. 2007;99(7):939-42.

81. Jose P, Skali H, Anavekar N, et al. Increase in creatinine and cardiovascular risk in patients with systolic dysfunction after myocardial infarction. J Am SocNephrol. 2006;17:2886-91.

82. Gottlieb SS, Abraham W, Butler J, et al. The prognostic importance of different definitions of worsening renal function in congestive heart failure. J Card Fail. 2002 8:136-41.

83. Cowie MR, Komajda M, Murray-Thomas T, et al. Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH). Eur Heart J. 2006;27:1216-22.

84. Ronco C, Bellomo R, McCullough PA. Cardiorenal syndromes in critical care. ContribNephrol. 2010; Basel, Karger, 2010, vol 165, 366 p.

85. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter., Suppl. 2012;2:1-138.

86. Tangri N, Grams ME, Levey AS, et al. Multinational Assessment of Accuracy of Equations for Predicting Risk of Kidney Failure: A Meta-analysis JAMA. 2016; 315(2):1-11. doi:10.1001/jama.2015.18202.

87. Vondenhoff S, Schunk SJ, Noels H. Increased cardiovascular risk in patients with chronic kidney disease. Herz. 2024;49:95-104.

88. Tkacheva ON, Kotovskaya YuV, Runikhina NK, et al. Clinical re­com­mendations of "Senile asthenia". Russian Journal of Geriatric Medicine. 2025;(1):6-48. (In Russ.) doi:10.37586/2686-8636-1-2025-6-48.

89. Ku E, Sarnak MJ, Toto R, et al. Effect of Blood Pressure Control on Long-Term Risk of End-Stage Renal Disease and Death Among Subgroups of Patients With Chronic Kidney Disease. J Am Heart Assoc. 2019;8(16):e012749. doi:10.1161/JAHA.119.012749.

90. Wright Jr JT, Bakris G, Greene T, et al. Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease: Results From the AASK Trial. JAMA. 2002;288(19):2421-31. doi:10.1001/jama.288.19.2421.

91. Ruggenenti P, Perna A, Loriga G, et al.; REIN-2 Study Group. Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial. Lancet. 2005;365(9463):939-46. doi:10.1016/S0140-6736(05)71082-5.

92. de Galan BE, Perkovic V, Ninomiya T, et al. ADVANCE Colla­bo­ra­tive Group. Lowering blood pressure reduces renal events in type 2 diabetes. J Am SocNephrol. 2009;20:883-92.

93. McEvoy JW, McCarthy CP, Bruno RM, et al.; ESC Scientific Do­cu­ment Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024; 45(38):3912-4018. doi:10.1093/eurheartj/ehae178. Erratum in: Eur Heart J. 2025;46(14):1300. doi:10.1093/eurheartj/ehaf031.

94. Wheeler DC, Stefánsson BV, Jongs N, et al. Effects of dapagliflozin on major adverse kidney and cardiovascular events in pa­tients with diabetic and non-diabetic chronic kidney disease: a prespecified analysis from the DAPA-CKD trial. Lancet Diabetes En­docrinol. 2021;9(1):22-31. doi:10.1016/S2213-8587(20)30369-7.

95. Zelniker TA, Wiviott SD, RazfI, et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 2019;393:31-9.

96. Perkovic V, Jardine MJ, Neal B, et al.; CREDENCE Trial Investigators. Canaglifozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380:2295-306.

97. Giugliano D, De Nicola L, Maiorino MI, et al. Preventing major adverse cardiovascular events by SGLT-2 inhibition in patients with type 2 diabetes: the role of kidney. Cardiovasc Diabetol. (2020);19:35. doi:10.1186/s12933-020-01010-x.

98. Bhatt DL, Szarek M, Pitt B, et al. Sotaglifozin in patients with diabetes and chronic kidney disease. N Engl J Med. 2021;384(2): 117-28. doi:10.1056/NEJMoa2030183.

99. Docherty KF, Jhund PS, Anand I, et al. Effect of dapaglifozin on outpatient worsening of patients with heart failure and reduced ejection fraction: a prespecified analysis of DAPA-HF. Circulation. 2020;142:1623-32.

100. Packer M, Anker SD, Butler J, et al. Cardiovascular and renal out­comes with empaglifozin in heart failure. N Engl J Med. 2020;383: 1413-24.

101. Heerspink HJL, Stefánsson BV, Correa-Rotter R, et al.; for the DAPA-CKD Trial Committees and Investigators. Dapaglifozin in patients with chronic kidney disease. N Engl J Med. 2020; 383:1436-46.

102. Herrington WG, Staplin N, Wanner C, et al. Empagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2023; 388(2):117-27. doi:10.1056/NEJMoa2204233.

103. Nuffield Department of Population Health Renal Studies Group; SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists' Consortium. Impact of diabetes on the effects of sodium glucose cotransporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet. 2022; 400(10365):1788-801. doi:10.1016/S0140-6736(22)02074-8.

104. Tsai WC, Hsu SP, Chiu YL, et al. Cardiovascular and renal efficacy and safety of sodium-glucose cotransporter-2 inhibitors in patients without diabetes: a systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2022;12(10):e060655. doi:10.1136/bmjopen-2021-060655.

105. Pitt B, Filippatos G, Agarwal R, et al.; FIGARO-DKD Investigators. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med. 2021;385:2252-63.

106. Agarwal R, Filippatos G, Pitt B, et al.; FIDELIO-DKD and FIGARO-DKD investigators. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney di­sease: the FIDELITY pooled analysis. Eur Heart J. 2022;43:474-84.

107. Rossing P, Anker SD, Filippatos G, et al.; FIDELIO-DKD and FIGARO-DKD Investigators. Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis. Diabetes Care. 2022;45:2991-8. doi:10.2337/dc22-0294.

108. Agarwal R, Fouque D. The foundation and the four pillars of treat­ment for cardiorenal protection in people with chronic kidney disease and type 2 diabetes. Nephrol Dial Transplant. 2023; 38(2):253-7. doi:10.1093/ndt/gfac331.

109. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension. 2018;71:1269-324.

110. Xie X, Liu Y, Perkovic V, et al. Renin-Angiotensin System Inhibitors and Kidney and Cardiovascular Outcomes in Patients With CKD: A Bayesian Network Meta-analysis of Randomized Clinical Trials. Am J Kidney Dis. 2016;67(5):728-41. doi:10.1053/j.ajkd.2015. 10.011.

111. Huang RS, Cheng YM, Zeng XX, et al. Renoprotective Effect of the Combination of Renin-angiotensin System Inhibitor and Calcium Channel Blocker in Patients with Hypertension and Chronic Kidney Disease. Chin Med J (Engl). 2016;129(5):562-9. doi:10.4103/0366-6999.176987.

112. The ACCORD Study Group. Effects of intensive blood-pressure con­trol in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575-85.

113. Beddhu S, Chertow GM, Greene T, et al. Effects of intensive systolic blood pressure lowering on cardiovascular events and mortality in patients with type 2 diabetes mellitus on standard glycemic control and in those without diabetes mellitus: reconciling results From ACCORD BP and SPRINT. J Am Heart Assoc. 2018;7(18):e9326. doi:10.1161/JAHA.118.009326.

114. Sarafidis PA, Blacklock R, Wood E, et al. Prevalence and factors associated with hyperkalemia in predialysis patients followed in a low-clearance clinic. Clin J Am SocNephrol. 2012;7:1234-41.

115. Sarafidis PA, Georgianos PI, Bakris GL. Advances in treatment of hyperkalemia in chronic kidney disease. Expert OpinPharmacother. 2015;16:2205-15.

116. Baigent C, Landray MJ, Reith C, et al.; SHARP Investigators. The ef­fects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomized placebo-controlled trial. Lancet. 2011;377:2181-92.

117. Herrington WG, Emberson J, Mihaylova B, et al. Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes Endocrinol. 2016; 4:829-39.

118. Barylski M, Nikfar S, Mikhailidis DP, et al.; Lipid and Blood Pressure Meta Analysis Collaboration Group. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy — a meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacol Res. 2013;72:35-44.

119. Charytan DM, Sabatine MS, Pedersen TR, et al.; FOURIER Steering Committee and Investigators. Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial. J Am CollCardiol. 2019;73:2961-70.

120. Wanner C, Tonelli M, Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. KidneyInt. 2014;85:1303-9.

121. Mach F, Baigent C, Catapano AL, et al.; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. EurHeart J. 2020;41:111-88.

122. de Boer IH, Khunti K, Sadusky T, et al. Diabetes Management in Chro­nic Kidney Disease: A Consensus Report by the American Di­abetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes Care. 2022;45(12):3075-90. doi:10.2337/dci22-0027.

123. Giugliano D, Bellastella G, Longo M, et al. Relationship between improvement of glycaemic control and reduction of major cardiovascular events in 15 cardiovascular outcome trials: A meta-analysis with meta-regression. Diabetes Obes Metab. 2020;22:1397-405.

124. Huang HD, Alam M, Hamzeh I, et al. Patients with severe chro­nic kidney disease benefit from early revascularization after acute coronary syndrome. Int J Cardiol. 2013;168:3741-6. doi:10.1016/j.ijcard.2013.06.013.

125. Szummer K, Lundman P, Jacobson SH, et al. Influence of renal func­tion on the effects of early revascularization in non-ST-elevation myocardial infarction: data from the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). Circulation. 2009;120:851-8. doi:10.1161/circulationaha.108.83816.

126. Szummer K, Lundman P, Jacobson SH, et al. Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome: data from the SWEDEHEART register. J Intern Med. 2010;268:40-9. doi:10.1111/j.1365-2796.2009.02204.x.

127. Averkov OV, Harutyunyan GK, Duplyakov DV, et al. 2024 Clinical practice guidelines for Acute coronary syndrome without ST segment elevation electrocardiogram. Russian Journal of Cardiology. 2025;30(5):6319. (In Russ.) doi:10.15829/1560-4071-2025-6319. EDN CXJUIB.

128. Averkov OV, Harutyunyan GK, Duplyakov DV, et al. 2024 Cli­ni­cal practice guidelines for Acute myocardial infarction with ST segment elevation electrocardiogram. Russian Journal of Cardiology. 2025;30(3):6306. (In Russ.) doi:10.15829/1560-4071-2025-6306. EDN IVJCUK.

129. Byrne RA, Rossello X, Coughlan JJ, et al.; ESC Scientific Docu­ment Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191. Erratum in: Eur Heart J. 2024; 45(13):1145. doi:10.1093/eurheartj/ehad870.

130. Davenport MS, Perazella MA, Yee J, et al. Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. KidneyMed. 2020;2:85-93. doi:10.1016/j.xkme.2020.01.001.

131. Tsai TT, Patel UD, Chang TI, et al. Contemporary incidence, pre­dictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry. J Am Coll Card Cardiovasc Interv. 2014;7(1):1-9. doi:10.1016/j.jcin.2013.06.016.

132. Watabe H, Sato A, Hoshi T, et al. Association of contrastinduced acute kidney injury with long-term cardiovascular events in acute coronary syndrome patients with chronic kidney disease undergoing emergent percutaneous coronary intervention. Int J Cardiol. 2014;174(1):57-63.

133. Belopukhov VM, Yakupov IF, Aynutdinova IA, Ivanova AY. Re­nal dysfunction in patients with myocardial infarction and percutaneous coronary interventions in the pre– and postoperative period. Medical Almanac 2013;4(28):55-6. (In Russ.)

134. Stacul F, Adam A, Becker CR, et al. Strategies to reduсe the risk of contrast — induced nephropathy. Am. J. Cardiol. 2006;98:59-77.

135. Mueller C. Prevention of contrast-induced nephropathy with volume supplementation. Kidney Int. Supplement. 2006;100:16-9.

136. Brar SS, Shen AY, Jorgensen MB, et al. Sodium bicarbonate vs sodium chloride for the prevention of contrast medium-induced nephropathy in patients undergoing coronary angiography: a randomized trial. JAMA. 2008;300(9):1038-46.

137. Кunadian V, Zaman A, Spyridopoulos I, et al. Sodium bi-carbonate for the prevention of contrast induced nephronpathy: a meta-analysis of published clinical trials. Eur. J. Radiol. 2011;79:48-55.

138. Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction ofcontrast-induced nephropathy after percutaneous coronary intervention: developmentand initial validation. J Am Coll Cardiol. 2004;44(7):1393-9.

139. Borovkova NYu, Ilyina AS, Spassky AA, et al. Cytoprotective therapy for renal injury in patients with acute ST-segment ele­vation myocardial infarction. Cardiology and Cardiovascular Sur­gery. 2017:1. (In Russ.) doi:10.17116/kardio201710138-41.

140. Sagynbaeva GA, Kaliev RR. Efficacy of N-acetylcysteine and mexidol in the prevention of contrast-induced nephropathy in patients with coronary heart disease. Science, New Technologies and Innovations of Kyrgyzstan. 2020:8. (In Russ.) doi:10.26104/NNTIK.2019.45.557.

141. Mullens W, Martens P, Testani JM, et al. Renal effects of guideline-directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2022;24(4):603-19. doi:10.1002/ejhf.2471.

142. Guaricci AI, Sturdà F, Russo R, et al. Assessment and ma­na­ge­ment of heart failure in patients with chronic kidney disease. Heart Fail Rev. 2023. doi:10.1007/s10741-023-10346-x.

143. Galyavich AS, Tereshchenko SN, Uskach TM, et al. 2024 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162. (In Russ.) doi:10.15829/1560-4071-2024-6162. EDN WKIDLJ.

144. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599-726. doi:10.1093/eurheartj/ehab368.

145. Vukadinović D, Lavall D, Vukadinović AN, et al. True rate of mineralocorticoid receptor antagonists related hyperkalemia in placebo-controlled trials: A meta-analysis. Am Heart J. 2017; 188:99-108. doi:10.1016/j.ahj.2017.03.011.

146. Wetmore JB, Yan H, Horne L, et al. Risk of hyperkalemia from reninangiotensin-aldosterone system inhibitors and factors as­sociated with treatment discontinuities in a real-world population. Nephrol Dial Transplant. 2021;36(5):826-39. doi:10.1093/ndt/gfz263.

147. Komajda M, Anker SD, Cowie MR, et al. Physicians’ adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey. Eur J Heart Fail. 2016;18(5):514-22. doi:10.1002/ejhf.510.

148. Beldhuis IE, Lam CSP, Testani JM, et al. Evidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease. Circulation. 2022; 145(9):693-712. doi:10.1161/CIRCULATIONAHA.121.052792.

149. Pontremoli R, Borghi C, Perrone Filardi P. Renal protection in chronic heart failure: focus on sacubitril/valsartan. Eur Heart J Cardiovasc Pharmacother. 2021;7(5):445-52. doi:10.1093/ehjcvp/pvab030.

150. Banerjee D, Rosano G, Herzog CA. Management of heart failure patient with CKD. Clin J Am Soc Nephrol. 2021;16(7):1131-9. doi:10.2215/CJN.14180920.

151. Bhatt DL, Verma S, Braunwald E. The DAPA-HF Trial: A Mo­men­tous Victory in the War against Heart Failure. Cell Metab. 2019; 30(5):847-9. doi:10.1016/j.cmet.2019.10.008.

152. Ferreira JP, Zannad F, Pocock SJ, et al. Interplay of Minera­lo­corticoid Receptor Antagonists and Empagliflozin in Heart Failure: EMPEROR-Reduced. J Am Coll Cardiol. 2021;77(11):1397-407. doi:10.1016/j.jacc.2021.01.044.

153. Pardo-Martínez P, Barge-Caballero E, Bouzas-Mosquera A, et al. Real world comparison of spironolactone and eplerenone in patients with heart failure. Eur J Intern Med. 2022;97:86-94. doi:10.1016/j.ejim.2021.12.027.

154. Zhirov IV, Safronova NV, Tereshchenko SN. Antagonists of mi­neralocorticoid receptors in patients with chronic heart failure: myths and reality. RMJ. 2024;6:9-14. (In Russ.)

155. Hindricks G, Potpara T, Dagres N, et al. ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. European Heart Journal. 2021;42(5):373-498.