Love your kidneys and heart

Sunday September 28, 2008

Love your kidneys and heart

There’s an intimate connection between your kidneys and heart.

TOO early? Ask Linda and she’ll tell you that women can get heart attacks way before menopause … especially if they have chronic kidney disease.

She was 44 when she first started feeling a dull pain in her back, somewhere just below the ribcage. It was tolerable at first so she didn’t get it checked out until several months later. The doctor said she had chronic kidney disease. Her damaged kidneys had also caused her to have high blood pressure. Three years later, at the age of 47, she got a heart attack.

Thankful to have survived, Linda advises all her friends to have their kidneys checked for their hearts’ sake.

Did you know that your cardiovascular risk starts rising even when kidney function is mildly impaired? Also, are you aware that cardiovascular disease accounts for more than 50% of all deaths among people with chronic kidney disease?

Those who are fortunate enough to escape but develop end-stage kidney failure are not better off as they will be 10 to 30 times more likely to die of a stroke, heart attack or some other cardiovascular problem, compared with the general adult population.

You might ask what all this has to do with you. A lot, if you currently have some form of kidney or heart disease, whether you are aware of it or not.

According to Dr S Prasad Menon, consultant nephrologist and member of the National Kidney Foundation of Malaysia, there is indeed a link between the state of your heart and kidneys. He says: “Doctors have been talking about the renal-cardiac syndrome for some years now. Also known as the cardio-renal syndrome, it basically suggests that any acute or chronic disease in either the heart or kidneys can affect the other organ in an acute or chronic manner. What this means is you may be able to prevent cardiovascular disease by protecting your kidneys, and vice versa.”

Dr Prasad explains how kidney disease harms the heart. “One of the functions of the kidneys is to regulate blood pressure. If they are diseased, high blood pressure results and this, in turn, further damages the kidneys. Uncontrolled high blood pressure will damage the body’s blood vessels and accelerate the development of a heart attack or stroke,” he says.

“As if this isn’t bad enough, hormonal secretion by the kidneys goes haywire when they are diseased. Anaemia also sets in. Should the kidneys fail, they will not be able to excrete water from the body, resulting in swelling due to water retention.

“All these factors, coupled with high blood pressure, cause an increased volume of blood in the circulation. Having to deal with the bigger load, the heart becomes enlarged and less efficient. As this happens, the heart has to increasingly work harder to pump blood to the body. Over time, the heart will tire and eventually fail.”

Dr Prasad is happy with growing public awareness of the classical cardiovascular risk factors. “For the sake of avoiding a heart attack or stroke, more people nowadays are making the effort to keep tabs on their body weight status, blood pressure and levels of blood cholesterol and blood glucose,” he remarks.

“Any risk factor needs to be dealt with. Take smoking, for example; it not only harms the heart but the kidneys, too. However, it’s important to realise that high blood glucose (or diabetes) and/or high blood pressure often signals trouble in the kidneys. Therefore, treatment for these conditions will not be complete unless the kidneys are also checked. If present, chronic kidney disease must be tackled as well,” he advises.

Dr Prasad recommends that everyone, regardless of their risk profile, should take a urine albumin test to detect kidney disease as part of their usual efforts to prevent cardiovascular disease. He also believes it should be part of every annual physical examination.

“In most cases, people with chronic kidney disease are not aware that they have it. The disease exhibits no symptoms until a very advanced stage. For this reason, we believe some 10% (or more) of the general public could be walking “time bombs”, going about their daily lives while remaining oblivious to the fact that their kidneys are deteriorating as each day passes. These individuals are at very high risk of being stricken by a stroke, heart attack or worse.

“So, taking a urine albumin test could be one of the best decisions anyone can make this World Heart Day. You never know what the results might show. When it comes to chronic kidney disease, early detection saves lives,” he concludes.

The risk of getting a heart attack is very real when you have chronic kidney disease. Equally devastating is the possibility of developing end-stage kidney failure and spending the rest of your life on dialysis with the fear of dying prematurely from cardiovascular disease. Don’t let this happen to you. Love your kidneys, save your heart.

> This article is courtesy of NKF Kidney Care, a community education programme by National Kidney Foundation of Malaysia. NKF provides subsidised dialysis treatments and free medications, laboratory tests, follow-ups and welfare assistance to need patients. For more details, please call NKF at the NKF Hotline: 1-300-88-3110 or log on to www.nkf.org.my.

http://thestar.com.my/health/story.asp?file=/2008/9/28/health/2090556&sec=health