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Kidney Disease & Heart Failure — the Relationship

How are the heart and kidneys linked?

Kidney disease and cardiovascular disease are closely linked. Research has shown that individuals living with kidney disease are at a higher risk of developing heart problems, and vice versa. Understanding the connection between these two conditions is crucial for preventing and managing these health issues.

The heart and the kidneys play a critical role in the health of the other. In fact, heart failure may worsen the symptoms of chronic kidney disease (CKD). It's imperative to consider heart health in kidney disease treatments, particularly by the time a person progresses to kidney failure. An appropriately prescribed kidney care plan may address some cardiac complications to help slow the progression of heart failure and kidney failure.

The heart and kidneys rely on one another to keep a person healthy, so heart failure and kidney disease are often associated with each other. As the heart pumps blood throughout the body, the blood picks up waste. The kidneys then filter that waste and excess water from the blood.

Because the heart pumps blood throughout the body, any compromise in cardiac function will adversely affect other systems in the body, like kidney function. If the heart is impacted, the kidneys won’t receive enough oxygen from the blood to perform functions like regulating blood pressure and producing red blood cells. And if the kidneys are not functioning normally, they aren’t able to filter waste and excess water from the blood, which can lead to fluid buildup and increase a person’s risk of high blood pressure and heart health complications.

What are some signs of heart failure and kidney failure?

Heart failure is a growing global public health issue, with an estimated 64 million people around the world diagnosed with this condition. Some signs of heart failure include:

  • Severe shortness of breath
  • Increased heart rate
  • Chest pain


Some signs of heart failure overlap with kidney failure, such as fatigue, decreased appetite, and swollen feet and ankles. However, it is recommended that people at risk for chronic kidney disease get screened yearly rather than wait for signs or symptoms to present. Some signs of kidney failure include:

  • Dry and itchy skin
  • Frequent urination
  • High blood pressure

How can patients better manage cardiovascular disease and kidney disease?

Slowing the progression of CKD is the first step for a person diagnosed with chronic kidney disease. Medications such as GLP-1 receptor agonists and SGLT-2 inhibitors, originally designed for people with type 2 diabetes mellitus, are thought to improve the control of blood glucose, blood pressure, body weight, and reduce the risk of different types of adverse cardiovascular events in diabetic patients, all of which could help slow the progression of CKD.

And of course, good habits like exercising regularly, eating a low-sodium diet, and avoiding smoking are excellent lifestyle choices to improve cardiac and renal outcomes.

Because CKD is a progressive disease, and as people lose their kidney function over time, dialysis becomes a necessary treatment to remove waste from blood and excess fluid when the kidneys are no longer functioning correctly. More frequent dialysis is one way to attain better cardiac outcomes in patients, especially because the aim of dialysis is to replace kidney function.

With more frequent dialysis, fewer medications may be needed for blood pressure control and constant fluid removal will reduce the consequences of chronic blood volume overload. Home dialysis, such as peritoneal dialysis or home hemodialysis, may also be an excellent option to deliver dialysis more frequently and more physiologically - both of which can help heart health.

When it comes to end stage kidney disease, it’s essential to care and prescribe for both the heart and the kidneys. It's very important that there be a working relationship between cardiologists and nephrologists to provide individualized and goal-directed prescriptions to treat renal patients.

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