The Crucial Connection: Simultaneous Heart and Kidney Management

The importance of simultaneous heart and kidney management


Complementary role in blood circulation function
Decreased kidney function leads to cardiovascular disease
Check whether microalbuminuria is detected in urine

The heart and kidneys (kidneys) are a community of destiny. The heart, which pumps blood throughout the body, and the kidneys, which filter wastes from the body, do different things, but they play complementary roles in maintaining the bodily function of blood circulation. When the heart is diseased, the kidneys are in danger, and when the kidneys are sick, the heart is in danger. Once the function of the heart and kidneys deteriorate, they are connected like a Mobius strip, creating a vicious cycle. We looked at the correlation between heart and kidney health, which are one hemodynamically.

The heart and kidneys are very closely connected by blood vessels. These two maintain systemic blood circulation while regulating blood pressure, electrolytes, and body fluid levels together. The relationship between the heart and kidneys is characterized by bidirectionality. Professor Jeon Jun-seok of the Department of Nephrology at Samsung Seoul Hospital warned, “If either of them has a health problem, there is a problem with blood circulation throughout the body, putting a burden on both the heart and kidneys.” This is the mind-body syndrome (CRS). The heart attacks the kidneys, and the kidneys attack the heart, irreversibly deteriorating. 70% of heart failure patients whose heart pump function has deteriorated to the limit state are accompanied by decreased kidney filtration function. 50% of chronic kidney disease patients receiving dialysis die of heart problems such as heart failure and acute myocardial infarction. This is the background that paid attention to the interaction between the heart and kidneys in the medical world.

If you suffer from high blood pressure or diabetes, you must check the glomerular filtration rate of your kidneys with urine and blood tests. Once the kidney is damaged, treatment is difficult and recovery is difficult. In order not to go into a state that requires dialysis, it is necessary to respond preemptively. Hallym University Hospital Nephrology Department Professor Kim Seong-kyun (Director of the Korean Society of Nephrology) said, “If the amount of blood filtered per minute from the glomerulus of the kidney is less than 60mL for more than 3 months, active treatment is needed to prevent the kidney function from getting worse.”

In particular, if blood pressure and blood sugar rise and are not well controlled even after increasing the dose or number of drugs, if the body swells well due to edema, or if the amount of urine decreases, it is a sign that the filtering function of the kidneys is deteriorating. As the coronary arteries connected to the heart narrow due to preceding diseases such as hypertension and diabetes, the pump function of the heart weakens and the kidneys are damaged due to systemic congestion in which blood is stagnant in the venous vessels. There are also studies that confirm this. Seoul National University Bundang Hospital Kim Se-joong and Seoul National University Hospital Professor Seung-seok Han’s team classified the patients into four groups according to the state of the heart’s pump function and then looked at the risk of kidney damage. As a result, the group with the weakest pump function, which contracts and relaxes the heart, had a 4.13 times higher risk of developing end-stage kidney disease requiring dialysis treatment than the group with the best.

People undergoing treatment for chronic kidney disease should be sensitive to signs of abnormalities sent by the heart. Gachon University Gil Hospital Cardiology Professor Oh Byeong-cheon said, “The decline in the filtering function of the kidneys is one of the important factors that cause cardiovascular disease.” Cardiac function declines due to various factors such as systemic inflammatory response accompanying kidney damage, excess body fluid, oxidative stress, and uremia. When the speed at which the kidneys filter wastes in the blood slows down, the amount of blood that can be filtered decreases, and wastes such as salt and water cannot be expelled. It is fatal to the heart. As unnecessary fluid accumulates in the body, blood pressure rises. As chronic kidney disease progressed and the severity increased, the prevalence of heart disease increased. In the first stage of chronic kidney disease, the prevalence of coronary artery disease, such as angina pectoris and myocardial infarction, was 0.8%.

What can I do to take care of heart and kidney health at the same time? First, it is integrated disease monitoring. Whether it’s the heart or the kidneys, if one area hurts, there’s a high chance that the rest of the area will also get sick. Even if there are no abnormal symptoms, tests to look at the function of the rest of the organs are necessary. If you are being treated for cardiovascular diseases such as high blood pressure, diabetes, or angina pectoris, check the level of glomerular filtration rate of the kidneys and whether microalbuminuria is not detected in the urine through blood and urine tests every year. Even in chronic kidney disease, cardiac ultrasound is used to check the heart condition.

Second, cardiovascular disease management. It is difficult to clearly distinguish which part of the heart or kidney problem occurs first. However, in general, there are many cases where abnormalities in the cardiovascular system occur and kidney function weakens over a certain period of time. Gangnam Severance Hospital Cardiology Professor Eui-Young Choi said, “Theoretically, the biggest cause of chronic kidney disease is blood flow disorder due to weakened pump function of the heart.” In other words, if you thoroughly control blood pressure and blood sugar, it means that it is positive for the kidneys.

Finally, exercise. If you practice aerobic exercise by walking for about 30 minutes a day, the blood vessels that make up the heart and blood vessels will be strengthened. It is also helpful in relieving symptoms of weakened heart and kidney function, such as leg swelling and shortness of breath.

Seonmi Kwon ([email protected])