Researchers from Brigham and Women’s Hospital, part of the Mass General Brigham healthcare system, have discovered significant links between heart failure and kidney disease, suggesting new integrated care approaches. An analysis of adults aged 65 and older, hospitalized for heart failure across 372 U.S. sites, revealed that about 6% of these patients required dialysis within a year of hospitalization. These findings were published in JAMA Cardiology.
John Ostrominski, MD, a fellow in Cardiovascular Medicine and Obesity Medicine at Brigham, highlighted that while heart and kidney health are interconnected, kidney health is often neglected in heart disease management until advanced stages. Declining kidney function is often asymptomatic until late stages but can have significant cardiovascular implications even at earlier stages.
The study utilized Medicare claims data from 85,298 patients over 65, hospitalized with heart failure between 2021 and 2024, sourced from the Get with the Guidelines-Heart-Failure Registry. It found that 63% of patients were discharged with significantly impaired kidney function. One year post-discharge, 6% of patients were on dialysis, and 7% had progressed to end-stage kidney disease or were on dialysis.
Ostrominski emphasized the need for cardiologists to prioritize kidney function assessment in heart failure patients. The study also called for systemic changes to support simultaneous heart and kidney disease management, such as integrated clinics, kidney outcome inclusion in healthcare metrics, and expanded Medicare reimbursement for interdisciplinary chronic care.
As reported by Medical Dialogues, researchers at Mass General Brigham are participating in clinical trials evaluating new treatment strategies for cardiovascular and kidney diseases. The Accelerator for Clinical Transformation team is developing innovative care delivery methods, including medications with kidney benefits.
Ostrominski concluded that while the trends were expected, the study underscores the problem’s scope and provides actionable information to improve clinical outcomes for heart failure patients. Opportunities exist for patients, providers, healthcare institutions, and policymakers to make significant improvements in care.