A routine venipuncture blood draw, the kind of test that produces the eGFR reading these guidelines call for in every heart disease patient
Richardelainechambers
Illustrative: a generic clinical blood draw, not a photograph of any patient in this guideline, any specific eGFR result, or the uACR urine test the guidelines also call for.
Europe's Cardiology Society Now Says Every Heart Disease Patient Should Get Two Kidney Tests
I read a lot of guideline coverage that buries the actual ask under a wall of hedging, so when Europe's cardiology society published its first ever kidney disease recommendations this week, the plainness of the instruction is what stood out to me. If you have heart disease, ask for two specific tests, an eGFR blood test and a urine albumin to creatinine ratio, because your heart and your kidneys are more connected than almost any standard heart health advice ever mentions.
- The European Society of Cardiology and the European Renal Association just published their first ever joint guidelines on managing heart disease and chronic kidney disease together.
- The core recommendation is concrete: the moment someone is diagnosed with cardiovascular disease, run two cheap tests, an eGFR blood test for kidney function and a urine albumin to creatinine ratio test, or uACR, that most patients have never been offered.
- About 100 million people in Europe have chronic kidney disease, and the two conditions speed each other up, so catching kidney involvement early changes how a cardiologist treats the heart condition itself, right down to which drugs get prioritized.
- This is a clinical guideline for people already diagnosed with heart disease, not a screening call for the general public, and it recommends zero supplements, a restraint worth naming out loud.
What the new guidelines actually recommend
The European Society of Cardiology, working with the European Renal Association, published its first guidelines dedicated specifically to managing heart disease and chronic kidney disease together, presented at ESC Congress 2026 and published in the European Heart Journal. The task force organized its recommendations under an acronym, STAMP on CKD, Screen, Triage, Address CKD risk, Modify CVD management, Plan health services. The Screen step is the concrete one: test every patient for chronic kidney disease the moment cardiovascular disease is diagnosed, using eGFR from a blood test and uACR from a urine sample. From there, Triage means using validated risk scoring tools that account for kidney function, and Address means starting proven, cost effective therapies early. Associate Professor Kevin Damman, who co chaired the task force, names RAS inhibitors and SGLT2 inhibitors alongside statin based therapy as particularly important and effective once kidney involvement is found. A plain language patient version of the guidelines was published alongside the clinical document.
Why your heart and kidneys accelerate each other
Kidney disease is famously silent until it is advanced, which is exactly why a guideline like this matters. An estimated 100 million people in Europe have chronic kidney disease, and the relationship between the two organs runs in both directions, heart disease speeds kidney decline and kidney disease speeds heart disease, each one making the other harder to manage. A guideline is also about as strong as evidence gets in this space. It is not one more single study making a splashy claim, it is the distilled consensus of a full expert task force reading the entire body of research and agreeing on what should actually change in a clinic. Professor William Herrington, the guideline's other co chair, said the explicit aim is to increase how often kidney function and urine albumin testing actually happen in patients with cardiovascular disease, because right now they mostly do not.
The two tests, explained in plain language
eGFR stands for estimated glomerular filtration rate, and it comes from a routine blood test that measures creatinine, a waste product your kidneys are supposed to filter out. A lower eGFR means your kidneys are filtering less efficiently. uACR stands for urine albumin to creatinine ratio, and it comes from a urine sample rather than blood. It checks whether albumin, a protein that should stay in your bloodstream, is leaking into your urine, which is often one of the earliest signs that kidney filtering is starting to break down, sometimes years before eGFR itself drops. Most patients have had a blood test like eGFR at some point. Far fewer have ever been offered the urine test, which is exactly the gap these guidelines are trying to close.
Honest caveat
This is a clinical guideline for people who already have a cardiovascular or kidney disease diagnosis. It is not a screening recommendation for healthy adults, and nothing in it suggests the general public should be requesting these tests. It is a European guideline from the ESC and ERA, and practice and insurance coverage in the United States may differ, and the 100 million prevalence figure is a Europe wide estimate. A guideline is expert consensus, which is a strong evidence class, but it is not itself new experimental data, and the task force explicitly notes that research is still needed to fill several remaining gaps. RAS inhibitors, SGLT2 inhibitors and statins are prescription medicines with their own risk profiles, and this is a prompt to talk to a clinician, not a protocol to self administer. Sama Says is not a substitute for medical advice, and this article is not one either. The document is only days old as of this writing, so independent commentary and any disputes have not yet had time to accumulate.
What this means for you
If you or a family member has been diagnosed with any cardiovascular condition, heart failure, coronary artery disease, atrial fibrillation, or anything else in that category, there are now two specific, named, inexpensive tests worth asking about at the next appointment, eGFR and uACR. Kidney disease being silent until it is advanced is exactly why waiting for symptoms is the wrong plan here. If a test comes back showing kidney involvement, this guideline is also a reason to ask specifically whether an SGLT2 inhibitor or a RAS inhibitor belongs in the treatment plan alongside a statin, since the task force names those as particularly effective once kidney and heart disease are both in the picture. None of this is a do it yourself protocol. It is a conversation to have with the doctor who already manages your heart condition.
Primary sources
- 2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease, in collaboration with the European Renal Association (ERA). European Heart Journal, 2026.
- Heart disease and kidney disease can fuel each other. New guidelines aim to break the cycle. ScienceDaily / European Society of Cardiology, September 5, 2026.
Common questions
What do eGFR and uACR actually measure?
eGFR, estimated glomerular filtration rate, is calculated from a routine blood test for creatinine and estimates how well your kidneys are filtering waste out of your blood. uACR, urine albumin to creatinine ratio, comes from a urine sample and measures whether protein is leaking into your urine, which is one of the earliest signs kidney filtering is starting to break down. The guidelines call for both together because each catches something the other can miss.
Does this mean healthy people should ask for these tests too?
No. This guideline is written for people who already have a cardiovascular disease diagnosis, not as a screening recommendation for the general public. If you or a family member has been diagnosed with any heart condition, it is a reasonable, specific thing to ask your doctor about at your next appointment. It is not a call for people with no heart disease diagnosis to request these tests on the strength of this guideline alone.
Why would a heart guideline recommend kidney tests?
Because heart disease and chronic kidney disease speed each other up, and kidney disease is often silent until it is advanced. The task force behind these guidelines found that testing for kidney involvement early changes how a cardiologist manages the heart condition itself, including which medications are prioritized and how existing heart drugs need to be dosed as kidney function changes.
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