Abstract: FR-PO0588
Myocardial Recovery in Dialysis-Dependent Patients After Optimization in a Multidisciplinary Cardiorenal Clinic: A Case Series
Session Information
- CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Helmke, Elizabeth, Oregon Health & Science University, Portland, Oregon, United States
- Macon, Conrad, Oregon Health & Science University, Portland, Oregon, United States
- Arora, Nayan, Oregon Health & Science University, Portland, Oregon, United States
Background
Patients with ESKD and heart failure with reduced ejection fraction (HFrEF) are underrepresented in HF trials, and HFrEF may limit kidney transplant (txp) eligibility. Here we describe a case series of dialysis patients incidentally found to have HFrEF during kidney txp work up and managed in our institution's multidisciplinary cardiorenal clinic (CRC).
Methods
This is a retrospective case series of adults on dialysis, seen in the CRC after being declined for kidney txp due to an ejection fraction (EF) <40%. A variety of variables, including baseline and follow up EF, medication utilization, dialysis modality, and time to follow-up were collected and displayed in Table 1.
Results
A total of 15 patients with HFrEF and ESKD on dialysis, were identified and included. Mean baseline EF was 28%. After optimization in CRC all patients were treated with a beta blocker, 14/15 patients were treated with an ARNI, 8/15 patients were treated with a SGLT2 inhibitor and 2 of 15 patients were treated with a mineralocorticoid receptor antagonist (MRA). 10 patients (67%) achieved myocardial recovery (Fig. 1). Of patients who achieved an EF >40%, there was variability in time to recovery (median 9.5 months, range 2-47 months). All 10 patients who achieved recovery were cleared for kidney txp. 5 patients experienced hyperkalemia, 7 had symptomatic intradialytic hypotension, and 1 had symptomatic bradycardia. 8 of 15 patients had their dialysis target weight increased to maintain medical therapy.
Conclusion
In this case series of dialysis patients with HFrEF, optimization of HFrEF therapy in a multidisciplinary CRC was associated with frequent myocardial recovery, facilitating a path to kidney txp. These findings support the critical need for further investigation of HFrEF optimization strategies in the dialysis population.