The Connection Between Heart and Kidney Disease

By Rachel Lane PhD, RD

February 5, 2019

Mike carefully inspected the miniature glass sculpture under the light and admired its flawless craftsmanship. “Too fragile to live in my home,” he thought, returning the figurine to the shelf. His cautiously retracting hand brushed a neighboring figurine, destabilizing it and - as if in slow motion - triggering a cascade of shattering glass animals. Mortified, Mike turned to face the store owner. “Don’t worry,” she replied reassuringly. “We have insurance.”

Our health is a lot like Mike’s experience in the glass shop: fragile and interconnected. Every day, over seventy organs in our body work together to ensure we wake up each morning, sleep in the evening, and complete a million tasks in between. This interdependence is typified by the heart and kidneys, which work together and depend on each other to provide the body with clean, nourishing blood.

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The heart pumps blood to organs and tissues throughout our body, delivering energy, oxygen and nutrients. Blood then passes through the kidneys, which remove toxins and waste so that fresh blood can be recirculated to the heart. If either organ falters, significant health problems occur, and the likelihood that the other organ will malfunction rises: heart dysfunction increases the risk of kidney failure and vice versa. When the heart and kidneys fail together (a state called “cardiorenal syndrome” (CRS)), expected lifespan decreases significantly.

The Clear Connection between Heart and Kidney Disease

The exact cause of CRS is unclear, but the association between heart and kidney disease and the interdependence of these two organs are uncontested. The United States Renal Data System reports that heart disease is nearly twice as common among patients (≤66 years old) with chronic kidney disease (64.5%) than among those without it (32.4%). This prevalence increases as kidney disease progresses: nearly 82% of patients with end-stage renal disease also suffer from heart disease. The only way patients with heart or kidney disease can prevent or delay CRS onset is to properly manage their current health condition.

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Protecting the Heart and Kidneys

Unlike the glass shop, our body doesn’t have an insurance policy that can eradicate damage. We must implement healthy lifestyle modifications  that properly manage associated risk factors (e.g., obesity, smoking, diabetes and/or high blood pressure (also called “hypertension”)) or the diagnosed condition. These modifications will prevent further damage and improve our quality of life. Yet, despite these potential benefits, we continually struggle to stick by our reformed values; instead, we return to the harmful habits that contributed to our diagnosis. What can be done to increase our success?

Compliance is Better than Perfection

New lifestyle modifications and medication regimens can sometimes feel like barriers, instead of tools, to a fulfilling life. When facing lifestyle changes due to a new diagnosis, it’s important to remember the goal: healthy living is an investment in the promise of tomorrow. To encourage success, proposed modifications should be realistic so that feasible short- and long-term goals can be set. Small, incremental modifications are more sustainable than large, instantaneous attempts at complete lifestyle overhauls.

Unrealistic goals can be detrimental to forward progress. When someone fails to achieve a goal instead of successfully completing it, that person is three times more likely to suffer from severe depression. The negative impact of this failure may be further increased when important goals, such as lifestyle modifications, are not met, making it even more difficult to accomplish the next attempt.  

Patients recently diagnosed with a disease need to advocate their own success by honestly assessing their capacity for change. For example, eliminating all sweets from the diet may not be feasible, but enjoying a special dessert (at a reasonable serving size) twice a week may feel like an attainable goal. Incrementally reducing salt intake by 100 mg per week may be more sustainable than completely removing it from the diet. Your goals are your responsibility; only you can determine what’s appropriate for your mind and body.

Togetherness

While the patient drives successful goal setting, long-term success requires a supportive community. Whether the goal is to prevent disease or support a suffering loved one, the importance of togetherness cannot be underestimated.

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Patients

Recently diagnosed patients might feel limited and isolated by new lifestyle modifications. Rather than being restrictive, these adjustments can liberate patients to embrace better choices. A strong social support system, with friends, family, and fellow patients who share the same commitments, can help you reach new lifestyle goals, reduce disease risk, and improve health. A supportive community that encourages you to live life to your fullest and honors your personal convictions will sustain your dedication to today’s commitments and your hope in the promise of tomorrow.

Friends and Family

The acceptance and encouragement of loved ones greatly ease the burden of newly diagnosed patients (see here, here, here and here). Patients may view new lifestyle modifications as a punishment or limitation rather than an investment. If you’ve ever missed out on an exciting hike because you sprained your ankle, forfeited your sea adventure because of motion sickness, or bailed on a concert because you came down with the flu, you’ve probably experienced the isolating effect limitations can impose. These limitations can lead to feelings of depression or helplessness in patients. A loved one’s support and encouragement can help combat those feelings and buoy patient morale.

As a loved one, you can show patients your support by embracing their new lifestyle, choosing to be a whole-hearted companion, and honoring the preferences that align with their commitment. This may include cooking – and eating – a low sodium meal or driving a patient to their dialysis treatment and staying to keep them company. There are many ways to support a patient just by choosing to be present and attentive!  

As patients become more comfortable with their new normal, continue to accommodate their needs and preferences as much as possible. Your support and companionship will strengthen the patient’s spirit and resolve. Just as your organs are interconnected and influence each other for better or worse, your attitude and outlook affect those of others.

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Living Better Together

Good health is never guaranteed, but compliance and togetherness are key to preventing the onset and progression of heart and kidney disease. We must be good stewards of our current health. Let’s make healthy choices that support our body, and let’s support each other by choosing a better life together.