2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease, in collaboration with the European Renal Association (ERA)

The first ESC guideline written for the kidney and the heart together, with the European Renal Association. It is built around STAMP on CKD — screening, triage and staging, addressing kidney risk, modifying cardiovascular management, planning services — and asks for eGFR and albuminuria in every cardiovascular patient as a Class I recommendation. The drug recommendations are written to thresholds rather than to labels: an SGLT2 inhibitor is Class I in type 2 diabetes with an eGFR of 20 or more, and without diabetes only when albuminuria reaches a uACR of 20 mg/mmol; finerenone is Class I in type 2 diabetes with an eGFR of 25 or more and a uACR of 3 mg/mmol or more; in heart failure with CKD the SGLT2 inhibitor is Class I irrespective of ejection fraction. A systolic target of 120–129 mmHg is Class I above an eGFR of 30, and a validated kidney failure risk equation is Class I for deciding who is referred to nephrology. The register's kidney and cardiorenal trials are grouped below.

This guideline cites 10 of the 199 landmark trials in our Cardiology register.

Source

Damman K, Herrington WG, et al. Eur Heart J. 2026; published online 28 August. · European Heart Journal

DOI

10.1093/eurheartj/ehag098