The first dedicated ESC Guidelines on the management of cardiovascular disease and chronic kidney disease recommend kidney function and urine albumin testing in all patients with cardiovascular disease, with an emphasis on identifying CKD early and initiating effective treatment without delay.
New European Society of Cardiology (ESC) Guidelines recommend that all patients with cardiovascular disease (CVD) be screened for chronic kidney disease (CKD), reflecting growing recognition of the close relationship between cardiovascular and kidney health.1-3
Published on August 28, 2026, in the European Heart Journal, the first ESC Guidelines dedicated specifically to the management of CVD and CKD were developed in collaboration with the European Renal Association (ERA) and are being presented at ESC Congress 2026 in Munich.1
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Around 100 million people in Europe are estimated to have CKD, which is associated with an increased risk of a wide range of cardiovascular diseases. CKD can accelerate CVD, while cardiovascular disease can also contribute to worsening kidney health, creating additional risks for patients with both conditions.3
“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 guideline Task Force Chair Associate Professor Kevin Damman, University Medical Centre Groningen, the Netherlands.3
However, recent therapeutic advances provide an opportunity to reduce these risks.
“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,” Associate Prof. Damman said.3
Screening for CKD in cardiovascular practice
A central recommendation is that all patients with CVD should be screened for CKD at diagnosis using both a blood test to determine estimated glomerular filtration rate (eGFR) from serum creatinine and a urine albumin-to-creatinine ratio (UACR).1
The guidelines aim to increase the use of both kidney function and urine albumin testing in cardiovascular practice, allowing more patients at increased kidney and cardiovascular risk to be recognized and treated.
“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,” explained Task Force Chair Professor William Herrington, University of Oxford, UK. “With improved screening, more at-risk patients can be identified and the most appropriate treatments for both CKD and CVD can be prescribed.”3
Putting a ‘STAMP on CKD’
To help translate the recommendations into clinical practice, the Task Force developed the STAMP on CKD framework:
- Screen
- Triage
- Address CKD risk
- Modify CVD management
- Plan health services
Following screening, patients should be appropriately triaged according to their risk of kidney failure and CVD using validated risk-assessment tools that incorporate kidney function.
The next step — addressing CKD risk — places particular emphasis on starting effective therapies early rather than leaving management to another clinician or specialty.
Speaking during the guideline presentation at ESC Congress 2026, Prof. Herrington highlighted the importance of the “A” in STAMP.
“Important is the A. We didn’t say this was action, but I think it should be A for action. It’s address risk,” he said. “Don’t leave this to someone else. Everyone with CKD deserves to be initiated on treatment as soon as it is identified.”
He added that the key information needed to guide initial treatment includes a patient’s diabetes status, eGFR, and urinary albumin level.2
Earlier treatment to protect the heart and kidneys
Addressing CKD risk includes early use of proven, cost-effective therapies that can slow CKD progression and reduce cardiovascular events.
“Early use of drugs called RAS inhibitors and SGLT2 inhibitors alongside statin-based therapy are particularly important and effective,” Associate Prof. Damman said.3
The guidelines also consider how the presence of CKD should modify the management of a wide range of cardiovascular conditions, including acute and chronic coronary syndromes, heart failure, arrhythmias, stroke, peripheral arterial disease, and sudden cardiac death.
This includes recommendations on treatment selection where reduced kidney function may affect the clearance or suitability of standard cardiovascular medications.
Greater collaboration between cardiology and nephrology
The final component of STAMP focuses on ensuring health services are able to recognize patients at highest risk and provide timely access to multidisciplinary care.1
“Active and efficient communication between specialties is often necessary due to the complexities associated with CKD,” Prof. Herrington said.3
“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 support shared decision-making between patients and healthcare professionals.
The Task Force hopes the new recommendations will improve recognition of CKD within cardiovascular practice and help ensure that patients receive treatments capable of reducing both kidney and cardiovascular complications.3
References
- European Society of Cardiology. 2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease. European Heart Journal. Published online August 28, 2026.
- European Society of Cardiology. 2026 ESC Guidelines for the Management of Cardiovascular Disease and Chronic Kidney Disease. Presented at ESC Congress 2026; August 27–31, 2026; Munich, Germany.
- European Society of Cardiology. New ESC guidelines recommend all patients with heart disease are tested for kidney disease. Press release. August 28, 2026.
Cite: New ESC guidelines recommend CKD screening for all patients with cardiovascular disease. touchCARDIO. August 28, 2026.
Disclosure: This content has been developed independently by Touch Medical Media for touchCARDIO, utilizing AI as an editorial tool (Claude (Sonnet 5) [Large language model] https://claude.ai). No funding was received in the publication of this article.
Editor: Nicola Cartridge, Director of Content
