Patients with coexisting heart failure (HF) and renal dysfunction (RD) face a significantly poorer prognosis compared to those with HF alone, experiencing higher rates of hospitalization, mortality, and morbidity. Managing patients with heart failure with reduced ejection fraction (HFrEF) and renal dysfunction (RD) is challenging due to the risk of further worsening of kidney function, particularly following an episode of acute decompensated heart failure (ADHF). Initiating a

Patients with documented left ventricular ejection fraction (LVEF) ≥ 50% are considered to have heart failure (HF) with preserved ejection fraction (HFpEF) (1). While HFpEF accounts for ~ 50% of patients with HF globally, it accounts for 15%–20% of patients with HF in India (2). HFpEF is characterized by increased left ventricular filling pressures and/or reduced cardiac output either at rest or on exertion. The body maintains the cardiac output by abnormally increasing the