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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

Heart and Kidney are inextricably linked

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*

3 Times High Overall Heart Failure with Microalbuminuria

Microalbuminuria has
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

Heart and Kidney Damage can result in Vicious Cycle

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||

*In a Dutch study of 195 screening-detected patients with T2D and 60 newly diagnosed diabetes in general practice, prevalence of microalbuminuria (ACR >2.0 mg/mmol) was 17.2% and 26.7%, respectively.4

Data from a study of patients with and without T2D. Of 2912 individuals with UACR, there were 122 (5.0%) heart failure events in individuals without microalbuminuria and 70 (14.0%) events among those with microalbuminuria (15+/-4 years of follow-up; 12.7 vs 3.6 events per 1000 person-years). UACR defined as ≥17 mg/g in men and ≥25 mg/g in women.3

Age-standardized rate (per 100 person-yr).5

§Age-standardized rate (per 100 person-yr). CV event was defined as hospitalization for coronary heart disease, heart failure, ischemic stroke, and peripheral arterial disease.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

ACR=albumin to creatinine ratio; CV=cardiovascular; CKD=chronic kidney disease; UACR=urine albumin to creatinine ratio.

References +

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.

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