The European Society of Cardiology has issued its first guidelines dedicated to managing cardiovascular disease alongside chronic kidney disease, developed in partnership with the European Renal Association. The recommendations were published in the European Heart Journal and presented at ESC Congress 2026.
Chronic kidney disease (CKD) is diagnosed when abnormalities in kidney structure or function persist for at least 3 months and affect a person’s health. An estimated 100 million people across Europe have CKD, and the condition substantially increases their risk of developing a range of cardiovascular diseases (CVD).
The Dangerous Link Between Heart and Kidney Disease
“The disability and lifetime lost to each disease are profound, but CKD can accelerate CVD and vice versa, resulting in cardiovascular events and the need for dialysis much earlier in life,” said Task Force Chair, Associate Professor Kevin Damman from University Medical Centre Groningen, Netherlands. “The good news is that there have been major advances over the last few years, which mean there are now several simple treatments that can substantially lower the risk of both cardiovascular and kidney complications.”
Because heart and kidney disease often occur together, the guidelines emphasize identifying kidney problems earlier in people already receiving treatment for cardiovascular disease.
Task Force Chair, Professor William Herrington from the University of Oxford, UK, noted: “Many patients with CKD are treated by the cardiology community and the new ESC Guidelines aim to increase the use of kidney function and urine albumin testing in patients with CVD. With improved screening, more at-risk patients can be identified, and the most appropriate treatments for both CKD and CVD can be prescribed.”
A New STAMP on CKD Strategy
To organize the recommendations, the Task Force created the ‘STAMP on CKD’ acronym: Screen, Triage, Address CKD Risk, Modify CVD management and Plan health services.
Screening is the first step. The guidelines recommend testing every patient with CVD for CKD when cardiovascular disease is diagnosed. This involves blood and urine testing (estimated glomerular filtration rate from blood creatinine plus urine albumin-to-creatinine ratio).
Triage then focuses on determining how likely a patient is to develop kidney failure, as well as evaluating cardiovascular risk. The guidelines recommend using validated risk scoring tools that take kidney function into account.
Earlier Treatment Could Reduce Complications
The next priority is addressing risk by introducing proven, cost-effective therapies early enough to slow the progression of CKD and lower the likelihood of cardiovascular events.
“Early use of drugs called RAS inhibitors and SGLT2 inhibitors alongside statin-based therapy are particularly important and effective,” explained Associate Prof. Damman.
The recommendations also identify situations in which cardiovascular treatment needs to be adjusted for people with CKD. Reduced kidney function can affect the body’s ability to clear certain medicines, so the guidelines provide advice about which treatments can be used safely when standard options may not be appropriate.
Coordinating Heart and Kidney Care
The final part of the strategy focuses on organizing healthcare services so that patients at greatest risk can be recognized quickly and receive timely care from both cardiologists and nephrologists.
“Active and efficient communication between specialties is often necessary due to the complexities associated with CKD,” noted Prof. Herrington. “Engagement of patients and family/caregivers in the multidisciplinary care process also helps to ensure patients’ priorities are met, improve their experience and promote patient-centered care.”
A patient version of the guidelines has also been developed to help people better understand their condition and participate more confidently in shared decisions with their healthcare providers.
The Task Force Chairs concluded, “CVD and CKD are major burdens on patients, healthcare systems and society. The key messages in these guidelines should be noted by all relevant healthcare stakeholders and policymakers, and research planned to fill several gaps in the evidence. Raising awareness will help realize the hope that the guidelines will lead to important individual and societal improvement for those with, or at risk of, CVD and CKD.”
