“The most common cause of chronic kidney disease is high blood pressure.”
It’s easy to think of your organs as individual structures that do their own thing, but everything in your body is interconnected. When one organ isn’t functioning at its best, it can have a domino effect on the rest of the body. This is the case with chronic kidney disease and heart health.
“There really is a strong connection between the kidneys and the heart,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “We'd like to think that the primary one has to do with blood pressure management, that the kidneys have a feedback loop that impacts blood pressure, but the connection is even deeper.”
Kidneys + the Heart
As you likely know, the heart is in charge of pumping blood to the rest of the organs. This helps the organs get the oxygen and other nutrients needed to function optimally.
The kidneys are in charge of cleaning the blood, filtering about half a cup of blood a minute. They remove excess water and waste products from the blood, which get sent to the bladder as urine. This also helps maintain a healthy balance of fluids in the body. (Learn more about the role of the kidneys in the body here.)
Your kidneys need your heart to pump healthy, oxygen-rich blood so they have the fuel to do their job. In return, your heart needs your kidneys to filter the blood to remove toxins and avoid extra work.
When Things Go Wrong
“We know that high blood pressure can impact both the kidneys and the heart. We know that the feedback loop can be changed,” says Dr. Phillips. “What that means is that a change in one of them always impacts the other, so a weakening of the heart can worsen kidney dysfunction.”
Likewise, dysfunctional kidneys may not make enough of the hormone erythropoietin (EPO), which helps produce red blood cells. This can cause anemia. Additionally, dysfunctional kidneys may not regulate the amount of fluid in the body and put extra strain on the heart. They may also cause dysregulation of electrolytes in the blood, which can impact the functioning of the heart.
In general, people who have kidney disease often have an increased risk of heart disease, atherosclerosis, heart failure, or other cardiovascular problems. Not surprisingly, kidney disease and heart disease can occur together, and they are thus treated in similar ways.
“We know that both kidney disease and heart disease are often progressive diseases, so by not modifying the risk and not controlling high blood pressure, you're [likely] going to end up having progressive worsening of the function,” says Dr. Phillips. “So for the kidneys, it's going to be worsening kidney disease, developing chronic condition and end-stage renal disease. And at the heart, it's the increased risk of having a heart attack and death.”
Thus, it’s important to have regular evaluations with your doctor so you can know your numbers, especially your blood pressure. They can help monitor your heart and kidney health, as well as advise you with heart-healthy lifestyle changes that can lower your risk of kidney and heart problems.
Lawrence Phillips, MD, is a cardiologist at NYU Langone Health. Dr. Phillips is the assistant professor of the Department of Medicine at NYU Grossman School of Medicine, the assistant clinical director for strategic affairs at Leon H. Charney Division of Cardiology, the director of the Nuclear Cardiology Laboratory, the medical director for Outpatient Clinical Cardiology, and the associate director of the Cardiovascular Disease Fellowship Program.
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There really is a strong connection
between the kidneys and the heart.
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We'd like to think that the primary one
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has to do with blood pressure management,
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that the kidneys have a feedback loop
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that impacts blood pressure,
but the connection is even deeper.
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So the most common cause of chronic kidney disease
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is high blood pressure.
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The second one being diabetes.
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Both of these cause repetitive damage to the kidneys,
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and therefore will result in chronic kidney disease.
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We know patients who have underlying kidney disease
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are at increased risk of developing heart disease.
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They're at increased risk of developing atherosclerosis.
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They're at increased risk of developing heart failure
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or heart dysfunction.
It's common that both disease states
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are seen together in patients, and therefore,
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when we address them and we treat them,
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we're addressing similar factors,
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such as high blood pressure, high cholesterol,
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making sure volume states are appropriate,
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and even in the medications that we use to treat them.
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So both for your heart and your kidneys,
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it's important to know your numbers,
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high blood pressure being the most important number
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to know, and to also know your goal.
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The second is if somebody has a risk of diabetes.
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Diabetes can impact both the heart and the kidneys,
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so you want to be aggressive
with your diabetes management,
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to lower the risk of developing progressive disease
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either in your heart or your kidneys.
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We know that both kidney disease and heart disease
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are often progressive diseases,
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so by not modifying the risk, and not controlling
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high blood pressure, you're going to end up
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having progressive worsening of the function.
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So for the kidneys, it's gonna be worsening kidney disease,
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developing chronic condition and end-stage renal disease.
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And in the heart, it's the increased risk of having
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a heart attack and death.
- Anemia in chronic kidney disease. Dallas, TX: American Heart Association. (Accessed on September 22, 2020)
- How high blood pressure can lead to kidney damage or failure. Dallas, TX: American Heart Association. (Accessed on September 22, 2020)
- Your kidneys & how they work. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on September 22, 2020)