The Heart and Kidneys are Closer Than You Think
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The interconnected functions of the heart and kidneys play an essential role in keeping our bodies healthy.
Having chronic kidney disease puts stress on the heart, which can lead to heart disease, the leading cause of death in the U.S. and worldwide.1,2
Sameer Bansilal, M.D., M.S., FACC, Vice President U.S. Medical Affairs, Cardiovascular at Bayer answered some frequently asked questions about the kidney and heart connection.
QUESTION: Many people may not be aware that the heart and kidneys are closely linked—can you describe the important relationship between the two?
ANSWER: Even though each organ in our body plays a specific role in keeping us healthy, they still rely on each other to function well. When the kidneys don’t work properly, they can’t filter toxins and waste out of the blood as effectively. This puts extra stress on the heart, which can cause new or worsen existing cardiovascular disease.1
The kidneys and endocrine system are also closely linked. Chronic kidney disease (CKD) is a frequent complication that patients may face due to their type 2 diabetes (T2D). CKD is also an independent risk factor of CV disease.3-5 CKD associated with T2D puts the heart under further stress, so patients with these diseases must be aware of and prioritize their heart health. These interconnected disease groups affect millions of people in the U.S. and significantly impact public health.6
QUESTION: What risks do patients with CKD associated with T2D face?
ANSWER: Many people with CKD associated with T2D are at risk for CKD progression and cardiovascular events.3,4,7,8 Patients living with CKD associated with T2D are three times more likely to die from a cardiovascular-related cause than those with T2D alone, emphasizing how important the kidneys are to our heart health.9 As CKD progresses, the risk for cardiovascular events3 and heart failure hospitalization increases.10
QUESTION: CKD is a frequent complication of T2D, affecting around 40% of patients.5 Given this significant prevalence and the associated cardiovascular risks, what are some treatment challenges that doctors and patients may face? What does the treatment landscape look like for patients with CKD associated with T2D?
ANSWER: Early diagnosis of CKD associated with T2D is critical. This is a challenge in and of itself because less than one-fifth of at-risk patients are tested for CKD using both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR).11 This means that kidney damage—and, therefore, potentially CKD—may be overlooked in many patients.
This is further complicated because CKD progresses slowly and silently. Most symptoms don’t appear until the disease is well advanced, and clinical signs are unspecific. Tiredness, nausea, insomnia, albumin (a protein) in urine, hypertension, swollen ankles, feet or hands, and itchy skin may be among CKD symptoms.12 Given this, it’s important to issue both eGFR and uACR tests to help patients get ahead of CKD progression and related cardiovascular events.13
As CKD progresses, leveraging every tool in the treatment toolbox is critical. Physicians have access to several recommended medicines for patients with CKD associated with T2D.8,14 These therapies, coupled with lifestyle modifications, can help improve cardiovascular and renal outcomes. Damage from CKD cannot be reversed, but patients and multidisciplinary care teams can work together to create a plan that may slow CKD progression and reduce cardiovascular risks.
QUESTION: Can you discuss Bayer’s connection to cardiology?
ANSWER: As one of the top five pharmaceutical companies worldwide in the field of cardiology, we are committed to continuing our history of researching and providing medicines to fight cardiovascular and kidney diseases.15 Our cardiovascular and renal portfolio includes several products and compounds in various stages of preclinical and clinical development. Through our robust pipeline, we also prioritize targets and pathways with the potential to impact how cardiovascular diseases are treated.
We are also committed to supporting patients beyond disease treatment, with a focus on educating them about the importance of early screening and intervention. When we combine treatment options with ongoing education and advocacy for patient access, we can truly advance care.
- Centers for Disease Control and Prevention. The surprising link between chronic kidney disease, diabetes, and heart disease. Accessed on October 13, 2022. https://www.cdc.gov/kidneydisease/publications-resources/link-between-ckd-diabetes-heart-disease.html#:~:text=When%20someone%20has%20CKD%2C%20their,can%20lead%20to%20heart%20disease
- World Health Organization. Cardiovascular diseases (CVDs). Accessed June 23, 2021. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
- Anders HJ, et al. CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease. Nat Rev Nephrol. 2018;14:361-377.
- Thomas MC, et al. Diabetic kidney disease. Nat Rev Dis Primers. 2015;1:1-20.
- Bailey R, et al. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7(1):415. doi:10.1186/1756-0500-7-415
- Benjamin EJ, et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. 2019;139:e56-e528.
- KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2013;3:1-150.
- American Diabetes Association. Standards of medical care in diabetes—2021. Diabetes Care. 2021;44(1):1-244.
- Afkarian M, et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013;24(2):302-308.
- Bansal N, et al. Burden and outcomes of heart failure hospitalizations in adults with chronic kidney disease. J Am Coll Cardiol. 2019;73(21):2691-2700. doi:10.1016/j.jacc.2019.02.071
- Alfego D, et al. Chronic kidney disease testing among at-risk adults in the U.S. remains low: real-world evidence from a national laboratory database. Diabetes Care. 2021;44(9):2025-2032. doi:10.2337/dc21-0723
- Bayer. Chronic kidney disease. Accessed October 13, 2022. https://www.bayer.com/en/pharma/chronic-kidney-disease
- Shlipak MG, et al. The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2021;99(1):34-47. doi:10.1016/j.kint.2020.10.012
- Blonde L, et al. American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan—2022 update. Endocr Pract. 2022;S1530-891X(22)00576-6. doi:10.1016/j.eprac.2022.08.002
- Schoening F. Presented at: Annual Bayer Pharma Media Day 2022; February 21, 2022. Virtual.