Chronic Kidney Disease and Cardiovascular Disease
Kidney disease affects the kidney's ability to clean the blood. The kidneys are the "renal system". Diabetes is the leading cause of kidney failure, high blood pressure is the second leading cause.
It has been know for some time that people with end-stage renal disease (ESRD) have much higher rates of death from cardiovascular disease than people without renal disease - 10 to 20 times higher. However, even people with mild chronic kidney disease are at high risk for cardiovascular disease. The National Kidney Foundation recommends that all patients with chronic kidney disease be considered at the highest risk for cardiovascular disease. This means that people with chronic kidney disease should be treated very aggressively to improve their cholesterol & lipids and blood pressure.
About one third of diabetics may develop kidney disease. The first sign of kidney damage is the presence of albumin (a type of protein) in the urine. A sensitive urine test for a tiny amount of albumin (microalbuminuria) helps to detect this damage at an early stage in people with diabetes. This is present long before there is evidence of kidney disease in the usual blood tests done in your doctor’s office. This is not only an early sign of kidney disease, but also of blood vessel abnormalities that may lead to heart disease. Other early signs of kidney disease in diabetics are needing to go to the bathroom more often at night or high blood pressure. The use of a special type of high blood pressure medicine called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function and reduce heart disease in diabetes. A related type of medicine, angiotensin II receptor blockers (ARBs), has also been shown to benefit patients with diabetes and chronic kidney disease. The best things to keep your kidneys working are controlling your blood sugar and high blood pressure with an ACE inhibitor or ARB. Your blood pressure should be 125/75 or less. In many cases, more than one high blood pressure medicine may be needed to reach this target.
Elevated creatinine in the blood is a sign of renal disease. A creatinine level above 1.2 mg/dL should cause suspicion. Your doctor or healthcare professional may treat elevated creatinine as a risk factor for heart disease. Hence, your blood pressure and cholesterol should be treated aggressively. This is espically true of older adults. According to the Cardiovascular Health Study, 60% of people over age 65 with a creatinine over 1.7 mg/dL died within 8 years, compared to a 17.5% death rate for people with a creatinine under 1.1 mg/dL.
The increase of cardiovascular disease in people with kidney disease is understandable since both diseases share several risk factors, including: diabetes, high blood pressure, lipid disorders, older age and physical inactivity. In addition, kidney disease can worsen high blood pressure, lipid disorders and elevate homocysteine, among other things.
Chronic Renal Disease includes:
Chronic Renal Insufficiency - elevation in serum creatinine concentration above the normal range.
End-Stage Renal Disease - kidney failure treated by dialysis.
Renal Transplant (kidney transplant)
