Renal Failure & Heart Disease

Of those diagnosed with chronic kidney malfunctions, more people actually die of heart disease than renal failure. End-stage renal disease is a condition wherein the kidneys are no longer independently capable of reasonable function. At that point, life must be sustained through outside methods, such as dialysis or kidney transplant. Even early onset of kidney disease, however, partners with a dramatic increase in the risk of suffering heart attack and stroke.
Medterms.com defines cardiovascular disease as: Disease affecting the heart or blood vessels.
Cardiovascular diseases include arteriosclerosis, coronary artery disease, heart valve disease, arrhythmia, heart failure, hypertension, orthostatic hypertension, shock, endocarditis, diseases of the aorta and its branches, disorders of the peripheral vascular system, and congenital heart disease.
Each of these conditions generate complications that inhibit proper kidney functioning. Heart disease and kidney disease are intertwined; either can exist as a consequence of the other, and when the presence of one is identified, the second is usually soon to follow.

What Renal Failure Can Do to the Heart

The indisposition of kidney disease yields secondary symptoms that constrain normal heart performance. Oxidative stress, anemia, inflammation and conditions that promote clotting are all detrimental side effects of kidney malfunction. Renal disease can also cause electrolyte imbalances, leading to cardiac arrhythmia, or irregular heart beat. Coronary artery disease may come about as a corollary of factors directly caused by chronic renal insufficiency.

How the Heart Affects the Kidneys

Renal vasoconstriction, which is the narrowing of the blood vessels resulting from contraction of the muscular wall, is an early symptom of congestive heart failure. Progressively, severe hypertension can do incredible damage to the kidneys, and much effort put toward lowering blood pressure in patients at risk is designed to avoid acute renal failure. Arterial hypertension, combined with a reduction in cardio output can lead to a complete shutdown of the kidneys and, perhaps, death.

Indicators

"Creatinine is a chemical waste molecule that is generated from muscle metabolism," as stated by Siamak Nabili, MD, MPH at medicinenet.com. He goes on to say, "The kidneys maintain the blood creatinine in a normal range. Creatinine has been found to be a fairly reliable indicator of kidney function." Serum creatinine levels of 71.7 mg/dl indicate a breakdown in normal renal operation. The problem is that a patient may already be well into dangerous territory by the time tests begin to depict suspicious levels. Two-thirds of kidney function may have already been lost. Albumin is a protein made by the liver. Microalbuminuria, which occurs when the kidney leaks small amounts of albumin into the urine, is a sign of kidney disease, and a strong predictor of cardiovascular disease. The appearance of this condition indicates a need to begin monitoring for other cardio risk factors. An imbalance in either organ will create a detrimental environment for the other.

Testing

The importance of monitoring the wellness of both systems is monumental. The Modification of Diet in Renal Disease (MDRD) formula is an equation alleged to estimate glomerular filtration rate (GFR) from serum creatinine, and stands as one of the best methods available for predicting kidney failure. With adequate testing, there may be a clear shot at reducing the mortality rate associated with renal failure, and consequent stress to the heart.

Treatment

Finding the right measure of drugs and lifestyle choices aimed at reducing blood pressure is a constant balancing act. Blocking sodium and water retention, which come at early stages of congenital heart failure, may reduce the chances of adding acute renal failure to the list. The National Kidney Disease Education Program aims to raise kidney awareness, and hopes that more doctors begin applying regular testing in their clinical practice. Of course, in otherwise healthy individuals, the ideal solution is to adopt a way of life that supports proper kidney and heart function in the long term. The saying, "An ounce of prevention is worth more than a pound of cure," goes well in this case.