Chronic kidney disease (CKD) is prevalent among patients with chronic heart failure (CHF), largely due to shared risk factors such as hypertension, diabetes, and dyslipidemia. In patients with heart failure with reduced ejection fraction (HFrEF), CKD prevalence is estimated between 40-60 %, and reduced glomerular filtration rate significantly worsens outcomes while complicating treatment optimization. Impaired cardiac output in CHF leads to reduced renal blood flow and perfusion gradient, activating maladaptive mechanisms that accelerate renal deterioration.
