Every heart patient should be checked for kidney disease, new guidelines say
What happened
The European Society of Cardiology has published its first ever guidelines on how heart disease and kidney disease should be managed together. The guidelines were written with the European Renal Association, which represents kidney specialists, and were presented at the ESC Congress in Munich at the end of August 2026. They were published in the European Heart Journal on 28 August 2026. The headline recommendation is short and specific. Everyone diagnosed with cardiovascular disease should be tested for chronic kidney disease at the time of diagnosis, using two simple tests: a blood test that estimates how well the kidneys filter, and a urine test that checks for protein leaking into the urine. The guidelines are built around a five-step framework the authors call STAMP: screen for kidney disease, triage by risk, address that risk with treatment, modify heart treatments where kidney function is reduced, and plan services so that heart and kidney specialists actually talk to each other. That last point sounds like paperwork. It is not. The guidelines note that active communication between specialties is often necessary because these patients are complicated.
Why this matters
Heart disease and kidney disease feed each other. Damaged kidneys put strain on the heart. A struggling heart reduces blood flow to the kidneys. Each one makes the other worse. The problem is that kidney disease is quiet. In its early stages there are usually no symptoms at all. People can lose a large share of their kidney function before they feel anything is wrong. Heart disease, by contrast, tends to announce itself. So the situation these guidelines are trying to fix is common: someone is treated for their heart, carefully and well, while a second condition sits underneath, undetected, making everything harder. The estimate quoted alongside the guidelines is that around 100 million people in Europe have chronic kidney disease, and that it substantially raises their cardiovascular risk. Many of them do not know they have it. The encouraging part is that the tests are neither expensive nor difficult. A blood test and a urine test are about as routine as medicine gets.
What the evidence actually says
Guidelines are not the same as new research. They are a group of specialists reading the existing evidence and agreeing what should now happen in practice. That is worth knowing when you read headlines about them. What the ESC and ERA have concluded is that the link between the two conditions is strong and well established, and that there are now treatments that lower the risk of both at once. The guidelines point to medicines including RAS inhibitors and SGLT2 inhibitors, which have been shown to protect the kidneys and the heart together. That is the practical reason for screening. Finding kidney disease is only useful if something can be done about it. Twenty years ago the answer was mostly monitoring. Today there are treatments that change the course of the disease. What these guidelines do not do is promise an outcome. They set out what good care should look like. Whether that reduces heart attacks and kidney failure across Europe depends on whether health systems actually adopt it, which the authors themselves flag as the hard part. It is also worth noting that these are European guidelines. In the UK, NICE sets the guidance the NHS follows. Guidance of this kind usually influences practice over time rather than overnight.
Practical advice
If you have been diagnosed with any form of heart disease, it is entirely reasonable to ask your GP or cardiologist a simple question: have my kidneys been checked, and when? Many people will find the answer is yes. Kidney function tests are already part of routine monitoring for a lot of long-term conditions, particularly if you take blood pressure medicines or have diabetes. The urine test for protein is the one more likely to have been missed. If you have diabetes or high blood pressure, the same question applies. These are the two biggest causes of chronic kidney disease. There are also everyday things that help both organs, and they are the familiar ones: keeping blood pressure under control, taking prescribed medicines consistently, not smoking, keeping active, and being careful with painkillers such as ibuprofen if you already have reduced kidney function. Ask your pharmacist about that last one, because it is easy to get wrong. Do not stop or change any medicine on the strength of a news article. If something here has raised a question, take it to your GP or pharmacist and ask.
What to know
Europe's heart doctors and kidney doctors have agreed, for the first time in a joint guideline, that everyone with cardiovascular disease should be screened for kidney disease when they are diagnosed. The tests are a blood test and a urine test. Kidney disease is common, silent in its early stages, and now treatable in ways that also protect the heart. The useful action for most readers is one question at your next appointment: have my kidneys been checked? Sources: European Society of Cardiology, '2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease', European Heart Journal, 28 August 2026, https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/cvd-chronic-kidney-disease/ ; ScienceDaily, 'Heart disease and kidney disease can fuel each other. New guidelines aim to break the cycle', 5 September 2026, https://www.sciencedaily.com/releases/2026/09/260902234447.htm This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. Never start, stop or change a prescribed medicine without speaking to your clinician first.
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