New heart care advice calls for earlier kidney screening

New European guidance says people diagnosed with cardiovascular disease should also be screened for chronic kidney disease. The goal is to detect kidney problems early enough for doctors to adjust treatment and lower the chance of complications affecting both organs.

Heart disease and kidney disease frequently appear together, but kidney trouble can be easy to miss, especially in the early stages. The recommendations say kidney testing should be included in the initial cardiovascular assessment.

The guidance was developed by the European Society of Cardiology together with the European Renal Association. Published in the European Heart Journal, it combines advice on detecting kidney disease, estimating risk, and coordinating care once problems are found.

The first step relies on two tests that provide different information. A blood test measures creatinine, which helps estimate how well the kidneys filter waste. A urine test looks for albumin, a protein that can leak into urine when the kidneys are damaged.

Using both results can give doctors a fuller picture than relying on filtration alone. Kidney damage may show up in urine before the estimated filtering rate reveals the full extent of the problem.

After kidney disease is identified, the guidance recommends validated tools to estimate the risk of kidney failure and cardiovascular complications. That can help determine who needs closer monitoring or specialist care.

The recommendations also support considering proven treatments early when they are suitable for the patient. These include medicines that act on the hormone system involved in blood pressure control, SGLT2 inhibitors, and statin-based treatment to reduce cardiovascular risk.

Information about kidney function can also influence how an existing heart condition is managed. Test results may affect drug choice, dosing, and the follow-up checks needed after treatment begins.

The guidance covers how services should work together as well as what happens during a visit. Shared care plans can help primary care teams, cardiologists, and kidney specialists decide who will arrange repeat testing and track the results.

Rather than reporting findings from a single new trial, the document brings together evidence for a care pathway. How much benefit earlier screening provides will depend partly on whether patients receive both tests and whether the findings lead to timely follow-up.

For someone already being treated for heart or blood vessel disease, the change is simple: checking for kidney damage at diagnosis creates a chance to spot a second condition while there is still time to adjust care and monitor its progress.