The human body is complicated, with systems and organs relying on each other to function. When one organ is not working correctly due to a condition, it can put additional stress on the other organs, stopping them from functioning correctly. One example of this interrelated and complicated relationship is between kidney disease and cardiovascular disease.
- Chronic kidney disease (CKD), even in the early stages, can cause high blood pressure, increasing the risk for heart disease.
- Both CKD and cardiovascular disease share risk factors such as hypertension, obesity, diabetes mellitus, smoking, and dyslipidemia.
- The healthcare industry must look beyond traditional cardiovascular disease risk factors to develop risk-lowering interventions to improve CKD patients’ health status.
Cardiovascular Disease Overview
Cardiovascular disease (CVD) describes conditions that affect the blood vessels or the heart. These conditions can affect one or more parts of the heart and blood vessels and prevent the heart from pumping blood as well as it should. Cardiovascular disease may include:
- Irregular heart rhythms
- Coronary artery disease (CAD)
- Heart valves that are not functioning properly
- Heart attack
- Narrowing of the blood vessels in the heart or throughout the body
- Cardiovascular problems present at birth
Symptoms of cardiovascular disease may be silent and only present when a person is experiencing signs of heart failure, heart attack, or arrhythmia.
Cardiovascular disease is one of the leading causes of fatalities in the U.S., with almost 50% of the population having some form of cardiovascular disease.
The most common causes of cardiovascular disease are hypertension (high blood pressure) and diabetes – the same as CKD. Cardiovascular disease risk factors also include:
- Family history of heart disease
- Hyperlipidemia (high cholesterol)
- Chronic kidney disease
- Overuse of alcohol
- Tobacco use
- Obesity or carrying excess weight
- Lack of physical activity
- Autoimmune or chronic inflammatory conditions
Chronic Kidney Disease Overview
CKD is a condition that affects 37 million people in the U.S. It is characterized by irreversible and progressive damage to the kidneys. When the kidneys are healthy and function properly, they remove waste products, toxins, and excess fluids from the bloodstream. They also play an essential role in stimulating the production of red blood cells and regulating chemical mechanisms that are vital to life.
Two of the most common causes of CKD are hypertension and diabetes. Other kidney conditions that can cause CKD include:
- Kidney cancer
- Lupus nephritis
- Polycystic kidney disease
When the kidneys are damaged, they can no longer filter blood, resulting in excess waste products and fluids remaining in the body. Complications of CKD include hypertension, cardiovascular disease, and diabetes.
Risk factors for developing CKD may include:
- A family history of CKD
- Hypertension (high blood pressure)
- Cardiovascular disease
Those with CKD may not experience any symptoms until the disease has progressed to later stages. The only definitive way to diagnose CKD is through specific urine or blood tests.
How the Kidneys and Cardiovascular System Work Together
The cardiovascular system is responsible for providing blood throughout the body. It is made up of the heart, blood, and blood vessels. The heart pumps oxygenated blood to the kidneys and the rest of the body. The kidneys then clean the blood, removing excess water and any waste products and toxins.
Without the kidneys cleaning the blood, there would be a build-up of waste products and excess water in the body. The heart would also be placed under additional strain, leading it to stop working. Without the cardiovascular system, the kidneys would not receive oxygen and other nutrients to keep them healthy.
Cardiovascular Disease and its Relationship with Chronic Kidney Disease
Cardiovascular disease and chronic kidney disease are closely interrelated. Having CKD means that there is an increased chance of developing cardiovascular disease. Cardiovascular disease can cause CKD, and it is one of the most common causes of fatalities among CKD patients on dialysis.
Patients with CKD have an increased risk of developing cardiovascular complications such as heart failure, arrhythmias, and sudden cardiac death. CKD populations are at a 20 times greater risk of developing premature cardiovascular disease compared to the general population.
Cardiovascular mortality risk significantly increases in CKD stages 3 and 4. Cardiovascular disease rather than kidney failure (end-stage kidney disease) is the leading cause of mortality in CKD patients.
There are two significant mechanisms that are thought to contribute to the development of cardiovascular disease in CKD patients. First, the kidneys may release hormones, cytokines, and enzymes in response to kidney damage, leading to adverse vascular system changes. Second, CKD-associated mediators and changes in the blood (build-up of waste products and water) contribute to heart damage.
The best solution to prevent cardiovascular disease is to prevent or treat the conditions that may cause it, such as hypertension, anemia, and diabetes.
Heart failure and CKD
Heart failure is a significant type of cardiovascular disease and has a high risk of hospital admissions and fatality. As the kidneys filter blood, they are susceptible to any problems with blood vessels or blood.
CKD has been linked with heart failure, as CKD patients have a higher risk of developing heart failure. This is due to the damaged kidneys not being able to clear waste and excess fluids effectively. Similarly, heart failure patients are at a higher risk of developing CKD as there is reduced blood flow to the kidneys.
Heart failure and CKD share many similar or the same risk factors, including high blood pressure and diabetes.
Blood clots and CKD
Having CKD may increase the risk of developing venous thromboembolism (VTE). The reasons for this are not yet well understood. The link between VTE and CKD may depend on how much kidney damage there is. CKD may make it easier for VTEs to form in the body. CKD patients who have nephrotic syndrome seem to have an increased risk of developing VTEs.
Keeping the Kidneys and Heart Healthy
The bidirectional relationship between cardiovascular disease and CKD is complex and requires a multidisciplinary care approach to manage and treat. Heart and kidney disease may be prevented or delayed by making healthy life choices such as:
- Reduce stress
- Heart and kidney-friendly diet
- Regular physical activity
- Stop smoking – if you smoke
- Lose weight – if needed
- Control blood pressure, cholesterol, and blood sugar levels
- Take medications exactly as prescribed
If you have CKD, testing for cardiovascular disease is vital as CKD is a risk factor for its development, and vice versa.
Panoramic Health is a physician-led, value-based kidney care platform that allows patients to receive holistic care coordination. Our team of nephrologists and care experts deliver comprehensive and full-spectrum care to CKD patients, resulting in reduced hospitalizations, lower costs, improved outcomes, and improved quality of life.