Heart and Kidney
picture by : http://www.worldkidneyday.org/resource/downloads-save-heart-poster/
By dr. Endin Nokik Stujanna, PhD
Do you know that often times patient with Heart disease also suffers from kidney disease or the other way around? Do you know why? This article will give you information about the relationship of the human organs between the heart and the kidneys . The human body is composed by a perfect networking system which is connected one to another. Like a computer, the human body is the CPU; if one system has problem, it will disturb the other networking . Like traffic, if the main road has congestion, it will also block others’ way. Heart and kidney are two important human organs and closely linked one to another. These two organs connect and influence each other ; they also work together. Both keep the body stay healthy. If heart fails to function well , kidney will usually has its bad impact or It can be the other way around.
How Heart works in the human body?
Heart is a muscle that pumps blood filled with oxygen to all parts of the body. These essential task keeps every cell, organ and system in the body alive and work well. Heart really depends on its vessels to move blood to all parts of the body including the kidneys and the heart. Together the heart, blood and blood vessels make up a system called the cardiovascular system. It is also known as “delivery system" or the circulatory system. Heart is the center of the circulatory system which is located inside the left chest. Heart can pump blood throughout the whole body. Contraction of the heart makes human’s heart beat. The circulatory system carries blood from the heart that is full of oxygen and nutrients to every part of the body. It also picks up the less oxygen blood
picture source : http://www.inaheart.or.id
How Kidneys work in the human body?
Kidneys are two soy bean-shaped organs and are usually about the size of your fist. Kidneys are located a little below your rib cage and to the left and right of your spine. Kidneys can be described as powerful chemical factories that clean blood by disposing residual substance and extra body fluid. Kidneys filter and get rid of waste like toxins, excessive salt, and urea. Kidneys also control blood pressure, maintain bone health, help the production of red blood cells, and keep the balance of minerals in the blood (such as sodium, phosphate and potassium). Besides that Kidneys produce the active vitamin D for bone health.
picture source : http://umich.edu/~elements/web_mod/viper/kidney_function.htm
How Heart and Kidneys work together in the human body?
Heart continuously pumps blood full of oxygen and sends it to all parts of the body, including the kidneys. Kidneys clean the blood, filter and dispose the residual substances and waste of the body metabolism and excessive liquid in the form of urine. In addition kidneys control the body moisture and salt to maintain blood pressure. Without kidneys, blood will have too much metabolism residual waste and fluid. Without kidneys, heart works very hard and cannot fully function. On the other hand, without heart, kidneys will not get full oxygen blood which is badly needed . The proper function of the cardiovascular system is very important for kidneys to do their job. Both organs work synergistically to run each function
What is the relationship between heart disease and kidney disease?
Scientists have been seriously doing the research to figure out the relationship between kidney disease and heart disease. If your heart or kidneys cannot normally function, it can cause cardiovascular disease or kidney disease. It is important to understand that kidney disease can directly affect your chances of having heart disease and having heart disease can directly affect your chances of having kidneys disease too. In fact, both kidney disease and heart disease have the same risk factors like diabetes and high blood pressure.
The latest research found that heart failure is the most significant risk factor of kidney disease. When heart cannot properly pump blood, blood cannot flow smoothly and this causes high blood pressure in kidneys major blood vessels which automatically affects the blood flow in the kidneys. Kidneys will have a shortage of oxygen-rich blood supply. On the other hand, when kidneys fail to work well, hormonal system which job is to control the blood pressure works hard to fullfil the increasing needs of the blood to the kidneys. And this makes heart work harder before finally overburden. Besides that the filtered blood flow to the heart gets weaker and it can cause complications in the heart. So, the weakness or failure of one organ (heart or kidneys) will have a bad impact on each other. Therefore, doctors will advise patients of kidney failure to do a routine kidney function test. Doctors will regularly check the blood pressure of patients with kidney failure and the probability of having heart problems.
Other term commonly used to describe the acute or chronic dysfunction in heart or kidneys which may lead to other organs dysfunction is called cardiorenal syndrome . Cardiorenal syndrome is a result of the interaction between the kidneys system and the cardiovascular system. Cardiorenal syndrome is classified into 5 types by Ronco. This topic will be discussed in this article in two parts. The first part is about how heart failure that affects the kidneys (Type II Cardiorenal syndrome). The second part is how heart is affected by kidney disease (type IV Cardiorenal syndrome). Many theories about pathophysiology have been revealed but still uncertain . In 2010 Paliliewu and Lefrandt stated that in heart failure case there is a decreasing function of systolic or diastolic in left ventricle which causes some haemodynamic changes including less cardiac output, stroke volume and arterial intake.
As a result, overload volume of fluid occured in the bloood vessel. If kidneys function is still proper, kidneys organ will help body to increase the diuresis and natrium excretion.
But if this continuouslyhappens, it can cause the kidney dysfunction that may trigger the patologic activation of the kidneys which influences the structure and function of the heart and the kidneys. Chronic kidney disease with uremia can also affect the structure and function of the heart. This condition will lead to atherosclerosis. Uremia has a number of abnormalities of cardiomiosit function. Some of them are cycles of cardiomiosit calcium and abnormal contraction.
According to Paganini, the interaction between the heart and the kidney takes place at the subcelular level through the neurohormonal channel. Activation of the neurohormonal is aldosterone, endothelin, angiotensin II, vasopressin, norephinephrin, cytokines and their balance with natriuritics peptides (ANP and BNP) which is the basic Pathology of heart failure. On the contrary all these factors can simultenously cause impaired kidney function
In normal condition haemodynamic is controlled by the heart while body fluid and electrolytes is controlled by the kidneys. Both systems mutually workin blood pressure autoregulatory. If blood flow in the heart increases or decreases then body fluid volume will respond automatically. This increasing or decreasing volume will stimulate the baroreceptor which through the neurohormonal systemgets the kidneys excrete or withhold the fluid and natrium ; this will also stimulate the blood vessels to do the vasodilatory/vasoconstriction. With this mechanism , blood pressure,fluid volumeand haemodynamic system can be maintained within normal limits (Bogartz dkk,2004; Stevenson et al, 2005; Van Kimmenade et al 2006).
Kidney failure or heart failure can cause anemia. While the anemia itself can cause heart failure or kidney failure. In kidney failure case, risk factors of anemia are the decreasing production of eritropoetin, chronic blood loss, drag of eritropoiesis caused by inflammatory, deficiency of nutrients, the existence of a secondary or hiperparatiroid accumulation of uremi fraction. In heart failure case particularly myocardial infarction, anemia is caused by the increasing number of cytokines - tumor necrosis factor α (TNF α) that influences the bone marrow erythrocytes progenitor. It also reduces the production of erythropoietin in the kidney. Moreover it interferes the iron release from the retikuloendotelial system which is used by the bone marrow to produce hemoglobin. Anemia in cardiorenal syndrome can further worsen the structure and function of the kidneys and the heart (Silverberg dkk, 2004)
What is the relationship between heart disease and kidney disease?
Scientists have been seriously doing the research to figure out the relationship between kidney disease and heart disease. If your heart or kidneys cannot normally function, it can cause cardiovascular disease or kidney disease. It is important to understand that kidney disease can directly affect your chances of having heart disease and having heart disease can directly affect your chances of having kidneys disease too. In fact, both kidney disease and heart disease have the same risk factors like diabetes and high blood pressure.
The latest research found that heart failure is the most significant risk factor of kidney disease. When heart cannot properly pump blood, blood cannot flow smoothly and this causes high blood pressure in kidneys major blood vessels which automatically affects the blood flow in the kidneys. Kidneys will have a shortage of oxygen-rich blood supply. On the other hand, when kidneys fail to work well, hormonal system which job is to control the blood pressure works hard to fullfil the increasing needs of the blood to the kidneys. And this makes heart work harder before finally overburden. Besides that the filtered blood flow to the heart gets weaker and it can cause complications in the heart. So, the weakness or failure of one organ (heart or kidneys) will have a bad impact on each other. Therefore, doctors will advise patients of kidney failure to do a routine kidney function test. Doctors will regularly check the blood pressure of patients with kidney failure and the probability of having heart problems.
Other term commonly used to describe the acute or chronic dysfunction in heart or kidneys which may lead to other organs dysfunction is called cardiorenal syndrome . Cardiorenal syndrome is a result of the interaction between the kidneys system and the cardiovascular system. Cardiorenal syndrome is classified into 5 types by Ronco. This topic will be discussed in this article in two parts. The first part is about how heart failure that affects the kidneys (Type II Cardiorenal syndrome). The second part is how heart is affected by kidney disease (type IV Cardiorenal syndrome). Many theories about pathophysiology have been revealed but still uncertain . In 2010 Paliliewu and Lefrandt stated that in heart failure case there is a decreasing function of systolic or diastolic in left ventricle which causes some haemodynamic changes including less cardiac output, stroke volume and arterial intake.
As a result, overload volume of fluid occured in the bloood vessel. If kidneys function is still proper, kidneys organ will help body to increase the diuresis and natrium excretion.
But if this continuouslyhappens, it can cause the kidney dysfunction that may trigger the patologic activation of the kidneys which influences the structure and function of the heart and the kidneys. Chronic kidney disease with uremia can also affect the structure and function of the heart. This condition will lead to atherosclerosis. Uremia has a number of abnormalities of cardiomiosit function. Some of them are cycles of cardiomiosit calcium and abnormal contraction.
According to Paganini, the interaction between the heart and the kidney takes place at the subcelular level through the neurohormonal channel. Activation of the neurohormonal is aldosterone, endothelin, angiotensin II, vasopressin, norephinephrin, cytokines and their balance with natriuritics peptides (ANP and BNP) which is the basic Pathology of heart failure. On the contrary all these factors can simultenously cause impaired kidney function
In normal condition haemodynamic is controlled by the heart while body fluid and electrolytes is controlled by the kidneys. Both systems mutually workin blood pressure autoregulatory. If blood flow in the heart increases or decreases then body fluid volume will respond automatically. This increasing or decreasing volume will stimulate the baroreceptor which through the neurohormonal systemgets the kidneys excrete or withhold the fluid and natrium ; this will also stimulate the blood vessels to do the vasodilatory/vasoconstriction. With this mechanism , blood pressure,fluid volumeand haemodynamic system can be maintained within normal limits (Bogartz dkk,2004; Stevenson et al, 2005; Van Kimmenade et al 2006).
Kidney failure or heart failure can cause anemia. While the anemia itself can cause heart failure or kidney failure. In kidney failure case, risk factors of anemia are the decreasing production of eritropoetin, chronic blood loss, drag of eritropoiesis caused by inflammatory, deficiency of nutrients, the existence of a secondary or hiperparatiroid accumulation of uremi fraction. In heart failure case particularly myocardial infarction, anemia is caused by the increasing number of cytokines - tumor necrosis factor α (TNF α) that influences the bone marrow erythrocytes progenitor. It also reduces the production of erythropoietin in the kidney. Moreover it interferes the iron release from the retikuloendotelial system which is used by the bone marrow to produce hemoglobin. Anemia in cardiorenal syndrome can further worsen the structure and function of the kidneys and the heart (Silverberg dkk, 2004)
Some tips to keep your kidney and heart in good condition
Don’t forget to always consult your healthcare provider to arrange your diet and lifestyle
· Regular exercise
· Lose weight if you are overweight
· Eat less fat
· Keep your blood sugar, blood pressure and blood fats under control
· Stop smoking
· Reduce stress
What if you have already kidney disease?
A person with kidney disease or kidney failure isat risk for heart disease. Consulting your healthcare provider will help you find the good way of diet and lifestyle that will lower your chances of getting heart disease or help keep heart disease from getting worse
What if you are on dialysis ?
Some tips below help you reduce chances of having heart disease or keep heart disease from getting worse..
· Check your blood sugar if you have diabete
· Control your high blood pressure
· Reduce your cholesterol
· Do exercise as advised and suggested by your doctor
· Get rid of your anemia
· Control the balance of Calcium and phosphor
· Stop smoking
· Reduce stress
The best way to keep your heart and kidneys healthy is to remember that what is good for your heart is also good for your kidneys. Keeping your kidneys healty makes your heart healthy too.
