Individualize BP-lowering therapy and treatment targets in people with frailty, high risk of falls, very
limited life expectancy, or symptomatic postural hypotension.
Treatments that delay progression of CKD with a strong evidence base include RASi and SGLT2i. In
people with CKD and heart failure, SGLT2i confer benefits irrespective of albuminuria.
Initial dips in eGFR are expected following initiation of hemodynamically active therapies, including both
RASI and SGLT2i. GFR reductions of ≥30% from baseline exceed the expected variability and warrant
evaluation.
CKD is not a contraindication to an invasive strategy for people with acute or unstable heart disease.
Imaging studies are not necessarily contraindicated in people with CKD and the risks and benefits should
be determined on an individual basis.
