The heart-kidney link
Ever wondered why heart and kidney diseases frequently become together? Dr Paul Kalra, consultant cardiologist at Queen Alexandra Hospital, Portsmouth, talks to Judy O’Sullivan near how our vital organs interact.
Imagine there’s been an blow on one of the motorways linking some of the UK’s major cities. Information technology’s rarely simply the one route that’due south affected – a traffic jam on one major route frequently leads to congestion on others.
The same is true for your torso. Think of your vital organs as key cities linked together past a network of motorways and main roads – the arteries and veins. When in that location’due south a problem in 1, things often go incorrect elsewhere. This is especially true of the centre and kidneys, which work very closely together.
How they piece of work together
The eye’s job is to transport a continuous supply of oxygenated blood effectually the body. The kidney filters the blood, extracting waste in the form of urine, and besides helps regulate the water and salt levels to control blood pressure level.
Relatively recent enquiry has shown that heart failure is a significant risk cistron for kidney disease
Relatively recent inquiry has shown that heart failure is a meaning risk cistron for kidney disease. When the centre is no longer pumping efficiently it becomes congested with blood, causing pressure level to build up in the main vein connected to the kidneys and leading to congestion of blood in the kidneys, as well. The kidneys likewise suffer from the reduced supply of oxygenated blood.
When the kidneys go dumb, the hormone system, which regulates blood pressure, goes into overdrive in an attempt to increase blood supply to the kidneys. The centre then has to pump confronting higher pressure in the arteries, and eventually suffers from the increase in workload.
It’s routine for doctors to check your kidney function if they believe you lot may have heart disease. A uncomplicated blood test can check if the level of creatinine, a waste product ordinarily secreted by the kidneys, is raised, suggesting impairment. Some patients may also need an ultrasound or CT scan to aid examine their kidneys’ structure and role.
Can it be treated?
Combined heart and kidney illness is unremarkably treated with several drugs. Command of high blood force per unit area is key.
H2o tablets, or diuretics, assist reduce blood pressure and remove excess fluid as they brand the kidneys excrete more water and salt. Swollen ankles are a common indication of excess fluid: talk to your doctor if this keeps happening to you.
Other drugs include ace inhibitors (ramipril, enalapril, lisinopril, perindopril), beta blockers (bisoprolol, carvedilol, nebivolol) and aldosterone blockers (spironolactone, eplerenone). These all benefit patients with heart failure as they counteract the over-activation of the hormone organisation. However, they can have a negative effect on the kidneys so it takes conscientious monitoring and frequent blood tests to get the balance right.
How you can reduce your risk:
- Be a non-smoker.
- Eat a depression-salt nutrition.
- Ask your dr. or nurse how to arrange drug dosage according to your claret test results and weight. Weigh yourself regularly at habitation to warn of fluid overload or aridity.
- Get to know your drugs – ask your md, specialist nurse or pharmacist to explicate.
- Practise regularly – swimming, cycling, dancing or power walking all aid to lower claret pressure and better center and muscle function.
Meet the expert
Dr Paul Kalra is a Consultant Cardiologist at Portsmouth Hospitals NHS Trust, and has a sub specialty interest in heart failure. He maintains an active research interest and has in excess of 70 peer reviewed publications. He is Britain Main Investigator for a worldwide epidemiological study for patients with coronary artery disease (Analyze), which has recruited almost 35,000 subjects (about 2,500 in United kingdom of great britain and northern ireland).
He has a clinical and academic involvement in patients with cardio-renal disease. He was co-organiser of the UKs outset national Cardio-Renal Conference in 2006; this has now developed into a very successful almanac meeting with around 150 delegates. He edited ‘Specialist Training in Cardiology’ which was Highly Commended in the 2006 BMA Medical Book Competition.