Heart Disease And Kidney Disease Link
New guidelines aim to break the cycle of heart and kidney disease fueling each other
Introduction To The Complex Relationship Between Heart And Kidney Disease
The European Society of Cardiology has recently issued its first guidelines dedicated to managing cardiovascular disease alongside chronic kidney disease, developed in partnership with the European Renal Association. This move is significant because chronic kidney disease (CKD) substantially increases the risk of developing a range of cardiovascular diseases (CVD), affecting an estimated 100 million people across Europe. The relationship between heart and kidney disease is complex, with each condition potentially fueling the progression of the other, leading to earlier onset of cardiovascular events and the need for dialysis.
Understanding The Risks And Consequences
Chronic kidney disease is diagnosed when abnormalities in kidney structure or function persist for at least 3 months and affect a person's health. The disability and lifetime lost to each disease are profound, but the interplay between CKD and CVD can accelerate the progression of both conditions. This dangerous link highlights the need for early identification and management of kidney problems in patients already receiving treatment for cardiovascular disease. By doing so, healthcare providers can substantially lower the risk of both cardiovascular and kidney complications.
Guidelines For Managing Cardiovascular Disease Alongside Chronic Kidney Disease
The new guidelines emphasize the importance of identifying kidney problems earlier in people with CVD. To achieve this, the guidelines recommend testing every patient with CVD for CKD when cardiovascular disease is diagnosed, using blood and urine testing. The 'STAMP on CKD' acronym was created to organize the recommendations: Screen, Triage, Address CKD Risk, Modify CVD management, and Plan health services. Screening is the first step, followed by triage to determine the likelihood of kidney failure and evaluate cardiovascular risk using validated risk scoring tools.
Early Treatment And Management Strategies
Early use of proven, cost-effective therapies is crucial to slow the progression of CKD and lower the likelihood of cardiovascular events. Drugs called RAS inhibitors and SGLT2 inhibitors, alongside statin-based therapy, are particularly important and effective. The guidelines also provide advice on adjusting cardiovascular treatment for people with CKD, considering the impact of reduced kidney function on the body's ability to clear certain medicines. Organizing healthcare services to recognize patients at greatest risk quickly and provide timely care from both cardiologists and nephrologists is also a key component of the strategy.
Implications And Future Outlook
The development of these guidelines marks a significant step forward in managing the complex relationship between heart and kidney disease. By increasing the use of kidney function and urine albumin testing in patients with CVD, more at-risk patients can be identified, and the most appropriate treatments for both CKD and CVD can be prescribed. Active and efficient communication between specialties, as well as engagement of patients and family/caregivers in the multidisciplinary care process, is essential to ensure patients' priorities are met and promote patient-centered care. A patient version of the guidelines has also been developed to help people better understand their condition and participate more confidently in shared decisions with their healthcare providers.
Sources
This is an original synthesis by Qivorane based on reporting from the outlets below.