INEXTRICABLY LINKED:THE HEART AND KIDNEYS IN TYPE 2 DIABETES (T2D)
Primary disorders of the heart or kidney often result in secondary dysfunction or injury to the other, representing the pathophysiological relationship between the two.
The relationship is characterized by the initiation and/or progression of renal insufficiency secondary to heart failure, but it may also be used to describe the negative effects of reduced renal function on the heart and circulation.
T2D IMPACTS THE HEART AND KIDNEY, LEADING TO AN INCREASE IN THE RISK OF HEART FAILURE1
The heart and kidney are both adversely affected by T2D.1
The heart and kidney are inextricably linked1
T2D DAMAGES THE KIDNEY, INCREASING THE RISK OF HEART FAILURE
Nearly 40% of patients with T2D have microalbuminuria.2
Damage to the kidney starts earlier than you may suspect—up to 1 in 4 patients with T2D had microalbuminuria at initial diagnosis3*
been associated with 3x
higher incidence rate of overall heart failure compared to those without microalbuminuria4†
HEART AND KIDNEY DAMAGE CAN RESULT IN A VICIOUS CYCLE
As the estimated glomerular filtration rate (eGFR) declines, the rate of CV events and hospitalizations increase.5
Based on a longitudinal cohort study of 1268 participants aged ≥65 years with eGFR <60 mL/min/1.73 m2. During 9.7 years of follow-up, the rate (per 100 person-years) was 0.5 for end-stage renal disease and 3.0 for CV death.6
Patients with CKD die of heart disease at 6x the rate than advancing to end-stage renal disease6||
1. Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-1539. 2. Parving HH, Brenner BM, McMurray JJ, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012;367:2204-2213. 3. Spijkerman AM, Dekker JM, Nijpels G, et al. Microvascular complications at time of diagnosis of type 2 diabetes are similar among diabetic patients detected by targeted screening and patients newly diagnosed in general practice: the Hoorn screening study. Diabetes Care. 2003;26:2604-2608. 4. Nayor M, Larson MG, Wang N, et al. The association of chronic kidney disease and microalbuminuria with heart failure with preserved vs. reduced ejection fraction. Eur J Heart Fail. 2017;19(5):615-623. 5. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296-1305. 6. Dalrymple LS, Katz R, Kestenbaum B, et al. Chronic kidney disease and the risk of end-stage renal disease versus death. J Gen Intern Med. 2010;26(4):379-385.
VIDEO: UNDERSTANDING RENAL DYSFUNCTION IN TYPE 2 DIABETES (T2D)
Clinicians share increasing concerns about the growing burden of diabetes due in part to the profound effects that the disease exerts on the heart, on atherosclerosis, and on the kidneys.
In this video, Dr. Katherine Tuttle, Professor of Medicine in the Division of Nephrology at the University of Washington, takes a look into the relationship between CV disease and renal disease, and discusses why it’s important to address renal dysfunction in patients with T2D.