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Globally, the rate of death from chronic kidney disease increased 24% from 1990 to 2021, according to statistics published by the American Heart Association. The rise in kidney disease rates is a major concern for cardiovascular health around the world. Kidney disease increases heart disease risk, yet as many as 9 in 10 U.
S. adults with chronic kidney disease do not know they have it. "Kidney disease is a powerful risk predictor, and treating it is a way to reduce morbidity and mortality of cardiovascular disease," said Janani Rangaswami, M.
D., FAHA, American Heart Association volunteer and professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C.
She explains that there is a connection between the "cardio-kidney domain"—the cross talk between the heart and kidneys—and the "cardio-metabolic domain" that creates an interplay of co-occurring conditions known as cardiovascular-kidney-metabolic (CKM) syndrome. About 1 in 3 U.S.
adults have at least three components of CKM syndrome. The broad impact of these conditions is why the Association developed its Cardiovascular-Kidney-Metabolic Health Initiative. Rangaswami is a member of the initiative's science advisory group.
Collaboration is key among health care professionals who treat people with both cardiovascular disease (CVD) and kidney disease. "Importantly, these conditions need to be thought about collectively because that's how patients experience them," said Mariell Jessup, M.D.
, FAHA, chief science and medical officer of the American Heart Association. "A holistic approach to care helps deliver better treatment and reduce the sense of 'overwhelm' that patients report about managing multiple chronic health conditions." "People living with kidney disease are often managing multiple other chronic conditions simultaneously, making collaborative care essential," said Amy Schuerman-Gen, M.
D., chief medical officer for DaVita Integrated Kidney Care. "We're tremendously proud to support the American Heart Association in this initiative to improve patient lives through interdisciplinary and more seamless care.
" Kidney disease and heart disease often develop together. Even early kidney damage raises the risk for cardiovascular disease, which includes heart disease, heart failure and stroke. Studies show that 3 in 5 people with early-stage kidney disease also have cardiovascular disease.
Two tests are used to screen for kidney disease. Urine albumin to creatinine ratio (UACR) uses a urine sample to look for a protein called albumin in urine, which may indicate early kidney damage. A UACR level of 30 or higher can be a sign of kidney disease and is linked to a high risk for CVD.
The second common test for kidney health is a blood test called estimated glomerular filtration rate, or eGFR. A healthy eGFR level is 90 or higher. Lower levels may mean a loss of kidney function.
"Interconnected cardiovascular, kidney, and metabolic conditions represent a major global health challenge," said Sandy Sommer, corporate senior vice president and head of therapeutic area cardiovascular, renal and metabolic at Boehringer Ingelheim. "Given the strong heart-kidney connection, advocating for earlier diagnosis and treatment of kidney disease can help protect the heart and reduce cardiovascular risk for the patients we serve." Metabolic health is a critical piece of the CKM puzzle because weight, blood pressure , lipids and blood glucose all play important roles in heart health and kidney health.
Excess body weight, especially around the waist, is linked with lower levels of kidney health. With each 10 pounds in weight gain over time, there can be as much as a 30% increase in risk for decreased kidney function. When these elements are controlled, cardiovascular health can improve and risks for kidney disease and other major health problems are lower.
Getting blood pressure, cholesterol, body fat, blood sugar and kidney health screened regularly can help detect signs of CKM syndrome early. This is especially important because the risk of death from CVD exceeds the risk of death from CKD, especially if someone has type 2 diabetes, said Rangaswami. CKM syndrome has four stages , with higher stages meaning more serious disease.
The early stages of CKM syndrome are reversible, but it is critical that individuals know their risk factors. "Understanding the connection between kidney health and heart health is critical to improving outcomes for people living with CKM syndrome," said Anna Windle, Ph.D.
, senior vice president of clinical development, medical and regulatory affairs at Novo Nordisk. "We are committed to raising awareness about the importance of kidney health and supporting health care professionals in adopting evidence-based practices that integrate kidney and cardiovascular care. This initiative aims to identify risks earlier, improve interdisciplinary care, and ultimately enhance patients' quality of life and improve their overall health outcomes.
" The initiative also aims to increase the use of evidence-based therapy for people with CKM syndrome, which decreases the likelihood of poor cardiovascular outcomes. Many adults in the U.S.
could benefit from the growing number of evidence-based therapeutic options for managing CKM risk and conditions such as managing blood sugar, reducing weight, improving kidney health and reducing the risk of heart attack and stroke..
