WORLD / Health
Kidney, heart disease spur each other
(AP)
Updated: 2007-06-26 10:44
WASHINGTON - Hearts and kidneys: If one's diseased, better keep a close
eye on the other. Surprising new research shows kidney disease somehow
speeds up heart disease well before it has ravaged the kidneys. And
perhaps not so surprising, doctors have finally proven that heart disease
can trigger kidney destruction, too.
The work, from two studies involving over 50,000 patients, promises to
boost efforts to diagnose simmering kidney disease earlier. All it takes
are urine and blood tests that cost less than $25, something proponents
want to become as routine as cholesterol checks.
"The average patient knows their cholesterol," says Dr. Peter McCullough,
preventive medicine chief at Michigan's William Beaumont Hospital. "The
average patient has no idea of their kidney function."
Chronic kidney disease, or CKD, is a quiet epidemic: Many of the 19
million Americans estimated to have it don't know they do. The kidneys
lose their ability to filter waste out of the bloodstream so slowly that
symptoms aren't obvious until the organs are very damaged. End-stage
kidney failure is rising fast, with 400,000 people requiring dialysis or
a transplant to survive, a toll that has doubled in each of the last two
decades.
And while CKD patients often are terrified of having to go on dialysis,
the hard truth is that most will die of heart disease before their
kidneys disintegrate to that point, something kidney specialists have
recognized for several years but isn't widely known.
Indeed, the new research is highlighted in this month's Archives of
Internal Medicine with a call for doctors who care for heart patients to
start rigorously checking out the kidneys - and for better care of early
kidney disease.
The link sounds logical. After all, high blood pressure and diabetes are
chief risk factors for both chronic kidney disease and heart attacks.
But the link goes beyond those risk factors, stresses McCullough: Once
the kidneys begin to fail, something in turn accelerates heart disease,
not just in the obviously sick or very old, but at what he calls "a
shockingly early age."
McCullough and colleagues tracked more than 37,000 relatively young
people - average age 53 - who volunteered for a kidney screening. Three
markers of kidney function were checked: The rate at which kidneys filter
blood, called the GFR or glomerular filtration rate; levels of the
protein albumin in the urine; and if they were anemic. They also were
asked about previously diagnosed heart disease.
The odds of having heart disease rose steadily as each of the kidney
markers worsened. More striking was the death data. At this age, few
deaths are expected, and indeed just 191 people died during the study
period. But those who had both CKD and known heart disease had a
threefold increased risk of death in a mere 2 1/2 years, mostly from
heart problems.
"This study is very much a wake-up call," McCullough says.
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