Cochrane · systematic review · CD012466
Pharmacological interventions for heart failure in people with chronic kidney disease
Lunney, M, Ruospo, M, Natale, P, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
36
current version
GRADE rated
19
No studies
17
Included studies
NR
No studies 17 · 47.2%Ungraded 0 · 0%Very low 7 · 19.4%Low 11 · 30.6%Moderate 1 · 2.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
ACUTE: Serelaxin versus placebo in patients with heart failure and chronic kidney disease
Population: heart failure with chronic kidney disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death (any cause) ACUTE: Serelaxin vs placebo | RR 0.59 [0.34, 1.02] | 2 studies · 1395 participants | Low Downgraded: risk of bias, inconsistency |
Cardiovascular death ACUTE: Serelaxin vs placebo | RR 0.47 [0.21, 1.08] | 2 studies · 1395 participants | Low Downgraded: risk of bias, inconsistency |
Hospitalisation (any cause) ACUTE: Serelaxin vs placebo | no estimate extracted | NR | No studies |
Heart failure hospitalisation ACUTE: Serelaxin vs placebo | no estimate extracted | NR | No studies |
Worsening heart failure ACUTE: Serelaxin vs placebo | RR 0.71 [0.54, 0.92] | 2 studies · 1395 participants | Low Downgraded: risk of bias, inconsistency |
Worsening kidney function ACUTE: Serelaxin vs placebo | RR 0.86 [0.37, 1.98] | 2 studies · 1395 participants | Low Downgraded: risk of bias, inconsistency |
Hypotension ACUTE: Serelaxin vs placebo | RR 1.26 [0.81, 1.96] | 2 studies · 1395 participants | Low Downgraded: risk of bias, inconsistency |
Hyperkalaemia ACUTE: Serelaxin vs placebo | RR 1.08 | 1 study · 234 participants | Very low Downgraded: risk of bias, inconsistency |
Quality of life ACUTE: Serelaxin vs placebo | no estimate extracted | NR | No studies |
CHRONIC: ACEi or ARB versus placebo in patients with heart failure and chronic kidney disease
Population: heart failure with chronic kidney disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death (any cause) ( CHRONIC: ACEi or ARB vs placebo | RR 0.85 [0.7, 1.02] | 4 studies · 5003 participants | Low Downgraded: risk of bias, inconsistency |
Cardiovascular death ( CHRONIC: ACEi or ARB vs placebo | RR 0.81 [0.64, 1.01] | 2 studies · 1368 participants | Low Downgraded: risk of bias, inconsistency |
Hospitalisation (any cause) CHRONIC: ACEi or ARB vs placebo | no estimate extracted | NR | No studies |
Heart failure hospitalisation ( CHRONIC: ACEi or ARB vs placebo | RR 0.9 [0.43, 1.9] | 2 studies · 1368 participants | Very low Downgraded: risk of bias, inconsistency |
Worsening heart failure CHRONIC: ACEi or ARB vs placebo | no estimate extracted | NR | No studies |
Worsening kidney function CHRONIC: ACEi or ARB vs placebo | no estimate extracted | NR | No studies |
Hypotension (ARB; withdrawn from study) CHRONIC: ACEi or ARB vs placebo | RR 2.6 [1.12, 6.07] | 1 study · 332 participants | Very low Downgraded: risk of bias, inconsistency |
Hyperkalaemia CHRONIC: ACEi or ARB vs placebo | no estimate extracted | NR | No studies |
Quality of life CHRONIC: ACEi or ARB vs placebo | no estimate extracted | NR | No studies |
CHRONIC: Beta‐blockers versus placebo in patients with heart failure and chronic kidney disease
Population: heart failure with chronic kidney disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death (any cause) ( CHRONIC: Beta‐blockers vs placebo | RR 0.69 [0.6, 0.79] | 4 studies · 3136 participants | Moderate Downgraded: risk of bias, inconsistency |
Cardiovascular death ( CHRONIC: Beta‐blockers vs placebo | RR 0.53 [0.35, 0.81] | 3 studies · 2287 participants | Low Downgraded: risk of bias, inconsistency |
Hospitalisation (any cause) CHRONIC: Beta‐blockers vs placebo | RR 0.75 [0.52, 1.08] | 2 studies · 1583 participants | Low Downgraded: risk of bias, inconsistency |
Heart failure hospitalisation ( CHRONIC: Beta‐blockers vs placebo | RR 0.67 [0.43, 1.05] | 3 studies · 2287 participants | Low Downgraded: risk of bias, inconsistency |
Worsening heart failure CHRONIC: Beta‐blockers vs placebo | RR 1.36 [0.58, 3.2] | 1 study · 704 participants | Very low Downgraded: risk of bias, inconsistency |
Worsening kidney function CHRONIC: Beta‐blockers vs placebo | no estimate extracted | 1 study · 704 participants | Very low Downgraded: risk of bias, inconsistency |
Hypotension CHRONIC: Beta‐blockers vs placebo | RR 5.11 [0.25, 106.15] | 1 study · 704 participants | Very low Downgraded: risk of bias, inconsistency |
Hyperkalaemia CHRONIC: Beta‐blockers vs placebo | no estimate extracted | NR | No studies |
Quality of life CHRONIC: Beta‐blockers vs placebo | no estimate extracted | NR | No studies |
CHRONIC: Aldosterone antagonists versus placebo in patients with heart failure and chronic kidney disease
Population: heart failure with chronic kidney disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death (any cause) ( CHRONIC: Aldosterone antagonists vs placebo | RR 0.61 [0.06, 6.59] | 2 studies · 34 participants | Very low Downgraded: risk of bias |
Cardiovascular death CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Hospitalisation (any cause) CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Heart failure hospitalisation CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Worsening heart failure CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Worsening kidney function CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Hypotension CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |
Hyperkalaemia CHRONIC: Aldosterone antagonists vs placebo | RR 2.91 [2.03, 4.17] | 3 studies · 826 participants | Low Downgraded: risk of bias |
Quality of life CHRONIC: Aldosterone antagonists vs placebo | no estimate extracted | NR | No studies |