Your heart and kidneys may have very different jobs, but when it comes to your health, the two are closely connected. A new clinical guideline is putting greater emphasis on that relationship and encouraging healthcare providers to identify and address risk factors earlier.
Released in June by the American Heart Association and American College of Cardiology, the new clinical guideline focuses on cardiovascular-kidney-metabolic, or CKM, syndrome. CKM describes how cardiovascular disease, kidney disease and metabolic conditions such as diabetes and obesity can influence one another and contribute to a person’s overall health risk.
For Gene Iucci, DO, FACC, a cardiologist who treats patients at Penn Cardiology Somers Point, the concept builds on a relationship that cardiologists have recognized for years.
“The heart and kidneys are very interrelated,” Iucci said. Blood pumped by the heart supplies the kidneys, while the kidneys help regulate processes that affect the cardiovascular system. When one isn’t functioning properly, it can put additional stress on the other.
That relationship can be particularly important for people with heart failure. Iucci explained that patients may have heart failure with reduced ejection fraction, meaning the heart’s pumping ability is weakened, or heart failure with preserved ejection fraction, in which the heart may become stiffer and have difficulty filling properly. Both can affect blood flow and pressures involving the kidneys.
Treatment requires physicians to consider both organs. Diuretics, for example, can help remove excess fluid and reduce pressure on the heart, but they can also affect kidney function.
“You don’t prioritize one over the other,” Iucci said. Instead, the goal is to find the balance that helps the patient feel better while monitoring both heart and kidney function.
The relationship can also work in the opposite direction. Kidney disease can contribute to cardiovascular problems, while high blood pressure and diabetes are major risk factors for both heart and kidney disease. Importantly, kidney disease does not have to be severe enough to require dialysis to matter. Many people live with earlier stages of chronic kidney disease that still warrant monitoring and treatment.
The new guideline encourages healthcare providers to recognize these connections earlier and coordinate care rather than treating each condition in isolation. It also addresses metabolic factors, including excess weight, blood sugar and cholesterol, that can contribute to both cardiovascular and kidney disease.
Treatment options increasingly reflect that same interconnected approach. Iucci pointed to SGLT2 inhibitors, including medications such as Jardiance and Farxiga, as an important example. Although originally developed to treat diabetes, this class of medication has demonstrated benefits for certain patients with heart failure and chronic kidney disease.
Other medications used for heart failure can also have important cardiovascular and kidney considerations. Depending on the patient and type of heart failure, treatment may include ACE inhibitors, angiotensin receptor-neprilysin inhibitors such as Entresto, beta blockers and mineralocorticoid receptor antagonists. The appropriate combination depends on the individual patient, making ongoing monitoring and coordinated medical care important.
The challenge is that early heart or kidney problems do not always cause obvious symptoms. Kidney disease may first appear through routine bloodwork, while cardiac testing can reveal changes in how well the heart pumps or relaxes before a patient develops significant symptoms.
That makes regular medical care and knowing your numbers particularly important. The new guideline reinforces a broader message: protecting your heart also means paying attention to your kidneys and the health factors that connect them.
To schedule an appointment with Gene Iucci, DO, FACC, at Penn Cardiology Somers Point, located on the second floor at 155 Medical Center Way, Somers Point, NJ 08244, call 609-365-3100.
