07/04/2007

Kidney, heart disease go hand in hand

By Lauran Neergaard
The Associated Press

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 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.

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.

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 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.”

What does the research mean for patients today?