Fewer Kidney Tests While Raising Heart Failure Medicine Doses
Tests whether fewer kidney checks allow higher doses of heart failure medicines.
Plain-language title generated from the registry record
Registry title: Effectiveness and Safety of Uptitration of Guideline Directed MEdical Therapy in Heart Failure With Reduced Ejection Fraction With Limited Kidney Function Assessments
Key facts
- Where
- Amsterdam and Leeuwarden, NetherlandsSee the 2 sites
Where in Netherlands
- Onze Lieve Vrouwe GasthuisAmsterdam, NetherlandsNo longer taking part
- Frisius MCLeeuwarden, NetherlandsNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- University Medical Center Groningen
- Trial code
- NCT07275437
- Record updated
- 18 December 2025
- Original description
Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) constitutes of four medications that substantially reduce morbidity and mortality, and improve quality of life. In routine clinical practice, various physician- and patient-related factors lead to suboptimal initiation and uptitration of GDMT to optimal dosing, which is associated with worse patient outcomes. A perceived major barrier to the optimalization of GDMT are changes in kidney function and electrolytes, which prompts physicians to halt uptitration, reduce doses, or even discontinue GDMT. Changes in kidney function and electrolytes during optimalization of GDMT are common, but not associated with adverse events.Read full original descriptionShow less
A Randomized, Controlled Trial Investigating the Effectiveness and Safety of Uptitration of Guideline Directed MEdical Therapy in Heart Failure With a Reduced Ejection Fraction With Limited Standardized Kidney Function Assessments (RESUME-HF-Kidney)
Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) constitutes of four medications that substantially reduce morbidity and mortality, and improve quality of life. In routine clinical practice, various physician- and patient-related factors lead to suboptimal initiation and uptitration of GDMT to optimal dosing, which is associated with worse patient outcomes. A perceived major barrier to the optimalization of GDMT are changes in kidney function and electrolytes, which prompts physicians to halt uptitration, reduce doses, or even discontinue GDMT. Changes in kidney function and electrolytes during optimalization of GDMT are common, but not associated with adverse events.
The hypothesis of this study is that a reduction in the number of kidney function assessments during initiation and uptitration of GDMT in HFrEF patients will lead to higher achieved doses of GDMT without safety concerns.
Inclusion: Able and willing to give written informed consent; Age ≥ 18 years; Diagnosed with HFrEF (LVEF≤ 45%) according to criteria from 2021 European Society of Cardiology guidelines for heart failure; Less than 100% target dose of 2 individual reno-active GDMT classes (ACEi/ARB/ARNI, MRA or SGLT-2i).
Exclusion: Decompensated heart failure requiring treatment with intravenous loop diuretics; Known concomitant structural kidney disease such as polycystic kidney disease or renal artery stenosis; Known intolerance or allergy to two individual GDMT; eGFR<25 mL/min/1.73 m2 measured up to 30 days before the first visit; Potassium > 5.5 mmol/L or <3.5 mmol/L at screening; Signs of hemodynamic instability and/or cardiogenic shock.