Kidney problems cause heart disease

Apart from being genetically predisposed to cardiac problems, research suggests that the increasing incidence of chronic kidney diseases could also mean more people dying of heart problems. The correlation between chronic kidney disease (CKD) and cardiovascular problem, though rarely highlighted, has become a point worth taking note.

A group of nephrologists from the National Society of Nephrology had started compiling patterns presented by patients to explain the increasing prevalence of kidney diseases since 2005. The database that comprises 30,000 cases now shows that diabetes was the cause for kidney failure in 30 per cent of the cases.

This data, published in a study by the All India Institute of Medical Sciences and Ministry of health and family welfare in February 2009, spoke about the correlation between cardiovascular and chronic kidney disease.

The study concluded that cardiovascular disease was seen more commonly as the stage of kidney disease progressed — 0.7 per cent in stage 1 to 43 per cent in stage 5 of kidney failure.

“The risk of a cardiac-related event is estimated to be between 3.5 and 50 times higher in patients with dialysis-dependent CKD than in the general population,” said Dr Gerard London, member of the Scientific Council of International Society of Hypertension, who was recently in the city. He said that patients with chronic kidney disease are more likely to die from premature cardiovascular death even before reaching the end stage of renal disease.

London added that cardiovascular disease is one of the most common causes of mortality in kidney disease patients on dialysis and accounts to as high as 40-50 per cent of deaths in them.

Explaining the condition, he said that once the kidneys fail, the body is unable to get rid of the excess phosphate in the blood.
“As excess phosphate starts building up, the patient develops a very high risk of developing complications like heart disease, bone damage, etc,” he said.

Also, as a treatment protocol, patients are prescribed phosphate binders to flush out the excess phosphate from the body.

And, the binders available in the market are either aluminum or calcium-based and the excess of both in the body have been found to create complications.“When the patient takes in too much calcium, it develops an excess calcium load that may spill over into other tissues,” said Dr Bhupendra Gandhi, consultant nephrologist, Jaslok Hospital.

 “Excess calcium and phosphate presence combines to form bony deposits in tissues and organs and go on to block blood vessels in the heart leading to a condition called cardiac calcification,” he said. “In such cases, mortality is very high and patients die of heart damage even as they are fighting a chronic kidney disease,” said Gandhi.