Heart disease linked to a higher risk of kidney failure

January 09, 2020

HighlightsWashington, DC (January 9, 2020) -- New research indicates that cardiovascular diseases--including heart failure, atrial fibrillation, coronary heart disease, and stroke--are each linked with a higher risk of developing kidney failure. The findings, which appear in an upcoming issue of JASN, highlight the importance of protecting the kidney health of individuals diagnosed with cardiovascular disease.

The heart and the kidneys have a bi-directional relationship, whereby dysfunction in either may compromise the function of the other. Many studies have investigated the risks of kidney disease on heart health, but few have examined the reciprocal relationship.

To investigate, a team led by Kunihiro Matsushita, MD, PhD and Junichi Ishigami, MD, PhD (Johns Hopkins Bloomberg School of Public Health) examined information on 9,047 US adults who did not have signs of heart disease when they enrolled in a community-based study.

"Many physicians probably recognize that patients with cardiovascular disease are at risk of kidney disease progression, but to my knowledge, this is the first study quantifying the contribution of different cardiovascular diseases to the development of kidney failure," said Dr. Matsushita.

During a median follow-up of 17.5 years, 2,598 participants were hospitalized with cardiovascular disease--1,269 with heart failure, 1,337 with atrial fibrillation, 696 with coronary heart disease, and 559 with stroke--and 210 patients developed kidney failure.

The incidence of major cardiovascular disease was associated with a higher risk of kidney failure, with the highest risk for heart failure. Participants hospitalized with heart failure had an 11.4-times higher risk of developing kidney failure than participants without cardiovascular disease.

"Individuals with a history of cardiovascular disease should be recognized as a high risk population for kidney failure. In this context, physicians should be aware of cardiovascular disease as an important risk condition, and thereby minimize treatments that are toxic to the kidneys in such individuals," said Dr. Ishigami. "Additionally, our findings may have implications for monitoring kidney function, although current cardiovascular disease guidelines do not necessarily specify the frequency of evaluating kidney function following the incidence of cardiovascular disease."
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Study co-authors include Logan Cowan, PhD, MPH, Ryan T. Demmer, PhD, MPH, Morgan E. Grams MD, PhD, Pamela L. Lutsey, PhD, MPH, Juan-Jesus Carrero, PhD, and Josef Coresh, MD, PhD.

Disclosures: Dr. Carrero reports grants from Astellas, AstraZeneca, MSD, Swedish Research Council, and ViforPharma, outside the submitted work. Dr. Coresh reports grants from National Institutes of Health, grants from National Kidney Foundation, during the conduct of the study. Dr. Grams reports nonfinancial support from DCI, nonfinancial support from Kidney Disease: Improving Global Outcomes, grants from National Institute of Diabetes and Digestive and Kidney Diseases, grants from National Kidney Foundation, outside the submitted work. Dr. Lutsey reports grants from National Institutes of Health during the conduct of the study. Dr. Matsushita reports personal fees from Akebia, grants and personal fees from Kyowa Kirin, outside the submitted work.

The article, entitled "Incidence of major cardiovascular diseases and subsequent risk of end-stage renal disease: the Atherosclerosis Risk in Communities (ARIC) Study," will appear online at http://jasn.asnjournals.org/ on January 9, 2020, doi: 10.1681/ASN.2019060574.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, the American Society of Nephrology (ASN) has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, visit http://www.asn-online.org.

American Society of Nephrology

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