Chronic Kidney Disease + Your Heart: What’s the Connection?

“The most common cause of chronic kidney disease is high blood pressure.”

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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.