Marx, NikolausCheng, Alice Y. Y.Agarwal, RajivGreene, Stephen J.Abuhantash, Hadi2023-10-042023-10-042022-12-19Marx N, Cheng AYY, Agarwal R, Greene SJ, Abuhantash H. Heart failure with reduced ejection fraction and the intersection of cardio-renal-metabolic medicine #CaReMe. Eur Heart J Suppl. 2022;24(Suppl L):L29-L37. Published 2022 Dec 19. doi:10.1093/eurheartjsupp/suac114https://hdl.handle.net/1805/36132Diabetes and chronic kidney disease (CKD) are important comorbidities in patients with heart failure (HF) that can complicate the clinical management and have major implications for morbidity and mortality. In addition, the presence of these comorbidities, particularly advanced CKD, is a limitation for the implementation of guideline-directed therapies in patients with HF with reduced ejection fraction (HFrEF). Though clinical trials in patients with HFrEF trials included varying percentages of patients with diabetes and/or CKD, patients with advanced CKD have been excluded in most HF studies. Thus, management recommendations for these patients often have to be extrapolated from subgroup analyses. This article summarizes pathophysiological aspects of the interaction of HFrEF, CKD, and diabetes and addresses clinical aspects for the screening of these comorbidities. Moreover, current treatment options for patients with HFrEF and CKD and/or diabetes are discussed and novel strategies such as the use of the selective mineralocorticoid receptor antagonist Finerenone are addressed.en-USAttribution-NonCommercial 4.0 InternationalHeart failureHFrEFDiabetesChronic kidney disease (CKD)Article