Friday, March 13, 2009


12th March is world kidney day. Looks like nowadays, to emphasize something is to proclaim a day of remembrance for it. Well, it is a good ide as we wish to emphasize that people take care of their kidneys. I thought that I should do my part by writing a little about the kidney's relationship to the heart.
I should begin by saying that the kidneys are very closely related to the heart. Maybe, not as close as diabetes ( diabetes is very closely related to blood vessels and the heart ), but close enough for us to call it a father-son relationship. Whatever happens to the kidneys will affect the heart ( we call it the renocardiac syndrome ) and whatever affects the heart will affect the kidneys ( we call it the cardio-renal syndrome ). What do I mean? Well, when the kidney function becomes compromised, whether acutely or chronically, waste products will accumulate and they will ultimately affect blood vessels ( as waste products are toxic and produce inflammatory effects on the blood vesel walls ), and the same waste products will also act to depress cardiac function. We measure blood urea and serum creatinine, as markers of renal function. They are not the only toxic products resulting from renal failure. There are many others. Arteriosclerosis is also a common result of renal failure and many renal failure patients die from heart attacks, and strokes. This is well known. Similarly, when a patient suffers from a fall in cardiac or vascular function ( heart failure or vascular failure or shock ), the resulting hypo-perfusion of the kidneys will quickly result in renal failure, and the cycle goes on. Needless to say that in the background of this continuum, is hypertension and diabetes, both common associates and also cause of heart disease and renal disease. I believe that when Dr Victor Tzau and Dr Eugene Braunwaul drew up the cardio-vascular continuum, in the 90s, they did not place quite enough emphasis in the role of the kidneys and renal disease in their continuum. Well, it may be time to revise that. In the area of obesity leading to hypertension, diabetes, we should also add renal disease ( acute or chronic ) to reflect the importance of the kidneys, the younger son of the heart.
Happy World Kidney Day and please do take care of your kidneys. They may cause your heart to sink. Please do take care of your heart. They may cause your kidneys to sink, too.

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