Peter McCullough, MD Baylor University Medical Center, Dallas, TX
The kidneys and the heart are inextricably connected: literally. The flow of blood and a variety of the body’s “communication systems” link the kidneys and the heart, including the nerves, to both organs and specific hormones that impact the way things work within the body.
The heart and blood vessels, also known as the vascular system, are responsible for pumping oxygen and nutrient rich blood through the arteries to vital life-sustaining organs. While the heart and vessels constantly pump blood throughout the body, the kidneys continuously filter this blood in order to remove waste products and excess fluid from the body.
The kidneys require more blood from the heart than any other organ, but in turn, the kidneys are responsible for managing salt and water levels in the body – the two biggest factors in determining the heart’s workload. Because the two organ systems work so closely together, lifestyle practices that increase risk for cardiovascular, or heart disease, also increase the risk for kidney disease. These include smoking, being overweight, and not controlling high blood pressure and diabetes. Because the heart and kidneys are interconnected, high blood pressure can cause both kidney disease and heart disease.
People with kidney failure are more likely to have heart disease and over the past several years we have learned that despite worries about heart attack and stroke in patients with kidney disease, the biggest hazard faced by these patients is either hospitalization for heart failure or sudden death. Both of these events are consequences of the heart muscle being affected by the chronic state of kidney failure.
There are new blood tests to better identify heart muscle problems, as well as newer ways to take better pictures of the heart. We are hopeful that newer treatments to improve performance of the heart or kidneys will positively impact the other organ system.
In the meantime, people with kidney disease should be vigilant in maintaining optimal blood pressure, favorable blood test results, and consider having a cardiology consultation if symptoms develop including chest pain, shortness of breath, exercise intolerance, and progressive swelling of the feet and legs.