When the heart can no longer pump blood efficiently throughout the body, kidney function issues are among the first complications to develop.

Congestive heart failure (CHF), a condition that reflects a weakened heart muscle and reduced circulation, can lead to kidney disease and other serious health complications. Kidney disease can also cause circulation problems and force the heart to pump harder, raising the risk of CHF.

CHF and kidney disease can be treated with medications and lifestyle adjustments. However, severe heart failure often needs more invasive treatment, and chronic kidney disease may ultimately require dialysis or a kidney transplant.

Working closely with your healthcare team to manage these two health challenges will give you the best chance of a positive outcome and a longer life.

A diagnosis of heart failure means your heart cannot pump enough blood to meet all the body’s demands. The condition can follow a heart attack or be a complication related to:

The term “congestive heart failure” refers to the congestion or fluid buildup in organs and tissue when blood pools in the veins instead of rushing back to the heart and lungs for oxygen.

The kidneys’ primary function is to filter toxins and waste material from the blood and help maintain healthy fluid levels in the body. A diagnosis of kidney disease means your kidneys are damaged and can no longer effectively carry out these functions.

A two-way relationship

The relationship between CHF and kidney disease is a two-way street. Having heart failure raises the risk of developing kidney disease.

CHF means there is less oxygenated blood nourishing the kidneys. When the blood flow from the heart slows and diminishes, it can cause blood flow back to the heart to back up in the veins of the organs, including the kidneys. Both problems can disrupt kidney function.

Likewise, if the kidneys stop filtering blood efficiently, they can cause the heart to work harder to keep healthy blood flow throughout the body. Over time, this additional burden on the heart can weaken its pumping ability, resulting in CHF.

While kidney problems can arise from even mild or early-stage heart failure, a 2021 study in the American Heart Association journal Circulation suggests that people with stage 4 and 5 chronic kidney disease are at increased risk of heart failure.

The main priorities for treating CHF and kidney disease are managing blood pressure and blood glucose (sugar) levels. Hypertension and diabetes are two major risk factors for CHF and kidney disease.

Diuretics may also reduce fluid retention and relieve symptoms, as CHF can cause your body to retain more fluid than it should.


Medications to lower high blood pressure and reduce fluid levels include diuretics, which make the kidneys excrete more sodium and fluids as urine.

Other blood pressure-lowering medications that may be prescribed include beta-blockers, which also help the heart beat more slowly and with less force, and ACE inhibitors.

Medications that help bring blood glucose levels into a healthy range include glucophage (Metformin) and other oral or injectable drugs.


For severe cases of CHF, a biventricular pacemaker may be needed to help both sides of the heart beat in a synchronized, consistent manner.

An implanted mechanical heart pump, such as a ventricular assist device or total artificial heart, can improve function when heart failure causes severely compromised circulation.

End-stage heart failure can sometimes be treated successfully with mechanical pumps, but in many cases, these devices are temporary while an individual awaits a heart transplant.

Kidney transplant

A kidney transplant may be the only option when the kidneys can no longer function. Before that, a person with severe kidney disease may require regular dialysis treatments.

Dialysis is a process that removes toxic chemicals from the body when the kidneys do not function normally.

Lifestyle behaviors

In addition to medical treatments, healthy lifestyle behaviors are recommended for those with CHF and kidney disease. Healthy lifestyle choices include:

Is it possible to recover from congestive heart failure and kidney disease?

CHF and kidney disease are progressive conditions, meaning they will usually worsen over time. However, with proper treatment and adherence to a healthy lifestyle, both conditions may be managed in many cases.

Heart failure may be reversible if the underlying cause is treated and there hasn’t been much damage to the heart muscle. It’s not possible to reverse kidney disease, but treatment can sometimes slow disease progression and preserve existing kidney function.

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The long-term outlook for someone with CHF and kidney disease depends on the severity of each condition and factors such as age and whether any other serious health problems are present.

A 2020 heart failure study suggests that the 5-year survival rate for anyone with heart failure is about 50%. But the study also notes that chronic kidney disease doubles the mortality risk.

A study published in 2021 examined the survival rates of people with heart failure, type 2 diabetes, kidney disease, or a combination of these conditions. Median survival for people with heart failure and diabetes was about 4.1 years, but just 2.2 years for individuals with heart failure and chronic kidney disease.

Because heart and kidney function are so closely tied, it’s not uncommon for someone with congestive heart failure to develop kidney disease, and vice versa. These two conditions can each pose serious health risks on their own and, in tandem, can pose even greater risks to survival.

With advances in medications and options for organ transplants and other therapies, managing the two health challenges can sometimes be possible, especially if diagnosed and treated early on.

The best way to lower your risk of developing both or either condition is to follow a balanced diet, exercise regularly, and keep up with your annual physicals and other health screenings.