How Is Chronic Kidney Disease Treated to Prevent Heart Complications?
For starters, your blood pressure will play a big role.
If you’ve been diagnosed with chronic kidney disease, your treatment won’t just aim to help and protect the kidneys. Kidney damage can actually have devastating effects on your cardiovascular system. Consequently, treating kidney disease to prevent heart problems is a major component of the treatment approach.
Complications of Chronic Kidney Disease
Your kidneys do several things for your heart. To name a few, they filter out waste from the blood, help control blood pressure, and help produce red blood cells. When the kidneys are damaged, these functions can be impaired, and the heart may have to work harder. Learn more about the link between kidney and heart problems here.
“Chronic kidney disease can cause complications both in the kidneys, as well as other organs in the body,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “For the heart, it increases your risk of developing heart complications, including heart failure or dysfunction.”
Additionally, if the kidneys are unable to filter out all the waste (which forms urine) from the blood, it can develop a buildup of toxins in the blood. As it progresses, someone may lose their ability to produce urine, and they require dialysis. This is called kidney failure.
Treatment to Prevent Complications
“One class of medications that becomes very important in treating both kidney disease with heart failure is diuretics. These are medications that help decrease the volume [of fluid] within the body,” says Dr. Phillips. “If people are swelling, for example, or have shortness of breath from fluid backup, we could decrease the volume in the blood vessels [and body] by giving diuretics.”
Another way to lower your risk of heart complications is managing your blood pressure, cholesterol, and blood sugar. These increase the risk of both kidney complications and heart complications. If necessary, your doctor may recommend medicines that can help lower blood pressure, cholesterol, and/or blood sugar.
Additionally, lifestyle factors play an important role in modifying your risk. A healthy diet—especially one low in sodium—can be beneficial for treating kidney and heart problems and preventing complications. Here are other heart-healthy lifestyle factors that can help.
It’s important to remember that heart problems stem from a “compilation of multiple risk factors,” says Dr. Phillips. “If somebody has one risk factor like kidney disease, we want to be extra aggressive on their other [risk factors], and that will decrease their risk overall of developing heart failure or heart disease.”
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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The goal of the kidneys is to filter the blood,
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and when there's repetitive damage to the kidneys,
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their function decreases
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and their ability to filter the blood worsens.
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So in chronic kidney disease, you're seeing a decrease
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in the functionality of the kidneys
and their ability to do their job.
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[upbeat music]
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So chronic kidney disease can cause complications
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both in the kidneys as well as other organs in the body.
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For the heart, it increases your risk of developing
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heart complications including heart failure
or dysfunction.
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The way to decrease cardiovascular complications
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when it comes to kidney disease is to modify the risk,
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often with medications.
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First and foremost being controlling blood pressure.
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And by controlling blood pressure, you're able to decrease
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progression of both the kidney disease
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as well as the heart disease.
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Beyond that, you want to look at other modifiable risk factors
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such as your cholesterol,
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and making sure that that's well controlled,
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and making sure that you're not causing further damage
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with either dietary or other lifestyle abnormalities.
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One thing that we worry about
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when it comes to kidney disease is salt intake,
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when it comes to the heart failure as well.
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Patients both will have some restrictions in their intake
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with what they're eating,
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but also will often be put on medications called diuretics.
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These are medications that help decrease the volume
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within the body,
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so if people are having swelling, for example,
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or shortness of breath from fluid backup,
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we can decrease the volume in the blood vessels,
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making them feel better and also decreasing risk
of complications.
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So when looking at cardiovascular disease
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in the setting of kidney disease,
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we know that the risk is increased
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but it's not absolute.
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And what I mean by that is, with all conditions
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that increase heart risk, it's not one condition
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causing an outcome, but rather,
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a compilation of multiple risk factors.
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So if somebody has one risk factor, like kidney disease,
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we want to be extra aggressive on their others,
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and that will decrease their risk overall
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of developing heart failure or heart disease.
- Key points: about dialysis for kidney failure. National Kidney Foundation. (Accessed on September 24, 2020)
- Overview of the management of chronic kidney disease in adults. Waltham, MA: UpToDate, 2020. (Accessed on September 24, 2020)
- Preventing chronic kidney disease. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 2016. (Accessed on September 24, 2020)