Europe's leading heart doctors want a simple change built into every cardiology visit. Anyone diagnosed with cardiovascular disease should also have their kidneys tested, according to the first joint guidelines on heart and kidney disease from the European Society of Cardiology (ESC), presented at the ESC Congress in Munich on August 29, 2026 and published in the European Heart Journal.
The recommendation is grounded in a well-documented but often overlooked problem. Heart disease and chronic kidney disease (CKD) feed one another, and catching CKD early opens up treatments that can slow both.
Why the two diseases travel together
CKD is a gradual loss of the kidneys' ability to filter waste from the blood. It rarely causes symptoms until the damage is advanced, which is why authorities describe it as under-recognized in primary care.
In the United States, about 35.5 million adults, roughly 1 in 7, are estimated to have CKD, according to the National Kidney Foundation.
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About 9 in 10 do not know they have it. The foundation notes that kidney disease and heart disease share risk factors such as diabetes and high blood pressure, and that each condition can lead to or worsen the other.
What the recommended screening looks like
The tests themselves are routine and inexpensive. The ESC guidelines call for two measurements when cardiovascular disease is diagnosed: a blood test to calculate the estimated glomerular filtration rate (eGFR) from creatinine, and a urine test for the albumin-to-creatinine ratio.
The eGFR shows how well the kidneys are filtering. Albumin in the urine is a protein that healthy kidneys keep in the blood, so any leak is an early sign of damage. Together, the two results place a patient in a risk category and shape follow-up.
The guidelines package the approach under an acronym the task force calls STAMP on CKD, short for Screen, Triage, Address CKD Risk, Modify CVD management, and Plan health services. In practice it moves kidney assessment from an occasional add-on to a standard step in cardiology care.
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The treatments that can break the cycle
The other half of the update is what to do when both conditions are present. Several drug classes now have strong evidence for protecting kidneys as well as the heart.
"Early use of drugs called RAS inhibitors and SGLT2 inhibitors alongside statin-based therapy are particularly important and effective," Damman said. RAS inhibitors, including ACE inhibitors and ARBs, ease pressure inside the kidney's filters. SGLT2 inhibitors were developed for type 2 diabetes but have been shown to slow kidney decline and cut heart failure events in people with and without diabetes. Statins lower LDL cholesterol and reduce cardiovascular risk across the CKD spectrum.
The document also covers when to add finerenone, a non-steroidal mineralocorticoid receptor antagonist, and how to adjust doses of common heart medicines when kidney function drops, because impaired kidneys clear certain drugs more slowly.
What it means for patients in the US
There is no US equivalent guideline that pairs cardiology and nephrology in the same way, which is part of why the ESC team pushed for one.
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For patients, the practical takeaway is small and specific. If you have coronary artery disease, heart failure, atrial fibrillation or a history of heart attack or stroke, and no one has recently checked your eGFR and urine albumin, it is reasonable to ask. The warning signs of kidney disease are easy to miss until the disease is well advanced, and the two blood and urine tests are among the least invasive in medicine.
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This article is made and published by Mie Hermansen, who may have used AI in the preparation.