American cardiologists warn against ignoring kidney disease

Many major organ systems are interconnected. Experts talk about “cardio-renal metabolic syndrome”.

While the so-called diseases of civilization in the “Western” world are not only common in these countries, all are apparently linked: cardiovascular disease (atherosclerosis), metabolic (e.g. diabetes) and kidney and liver diseases (e.g. MASH). . It was only last October that the American Heart Association (AHA) called for special attention to be paid to the threat of chronic kidney disease.

Until now, obesity, high blood pressure, high cholesterol levels and insulin resistance, the latter a potential “precursor” of type 2 diabetes, were seen as warning signs. In this context, medicine talked about syndrome X, then about metabolic syndrome. However, the global problem of obesity, diabetes, cardiovascular diseases and the often associated chronic progressive fatty liver disease (MASH) still needs to be seen in a larger context. So the American Heart Association (AHA) has taken a new step. In their special issue “Circulation” they call not to “forget” about the kidneys when it comes to metabolic syndrome in the future. It is better to talk about “cardiovascular-renal metabolic syndrome” (CKM).

“The starting point for the new disease concept is that there are high risk factors in a population that simultaneously promote the development of heart disease, metabolic disorders, and/or kidney disease. According to the AHA, in the United States, one in three adults have at least three risk factors. For example, any long-term damage to the kidney affects the heart. has an adverse effect.

The AHA stated: “Many aspects of cardiovascular disease overlap with (chronic) kidney disease. Type 2 diabetes and obesity support this new approach.” Guidelines and guidelines for victims need to be reformulated. “The task force proposes parameters that allow for 10-year and 30-year cardiovascular disease risk,” the American Heart Association said in a statement. In this way, in suspected cases, targeted prevention can be carried out decades before an apparent outbreak of cardiovascular, metabolic or renal disease. “CKM affects almost all major organs, including the heart, brain, kidneys, and liver.”

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On the one hand, AHA experts want measures of kidney function and blood sugar control to be included in the calculations, and on the other hand, psychological and economic factors should also be included. Algorithms should also be used at age 30. You cannot start early.

“Screening for kidney and metabolic diseases will help us start preventive treatments earlier. This will help prevent heart disease effectively on the one hand, but on the other hand improve the management of pre-existing diseases,” said Chiadi Nedumele, Director of Obesity. and Cardiovascular Research Program – Metabolism at Johns Hopkins University, Baltimore (USA).

This concept is also supported by existing therapeutic strategies: some drugs for high blood pressure, as well as new drugs for the treatment of type 2 diabetes and weight loss, as well as active substances for lowering the concentration of cholesterol in the blood, with one of their effects on the blood vessels, heart, kidneys and other organs or organ systems. One.

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