The Way To Your Heart Is Through Your Kidneys!

The Way To Your Heart Is Through Your Kidneys!

Romantics are not going to like this but the heart is overrated. Major emotions like love, respect and affection are attributed to the heart. Poets and writers have written a gazillion pages extolling the role of the heart in influencing our social interactions, our thoughts, our feelings, our actions and so on. The heart has always been perceived to be the most versatile, useful and important organ in our body.

The truth is, the heart is just a mechanical pump whose only role is to pump blood to all parts of the body. By doing this, it provides oxygen and nutrients to the rest of the body. If for any reason, the heart stops beating (also called cardiac arrest or heart attack), the other parts of the body do not receive blood and oxygen and start getting damaged.

Till 1960, it was thought that cardiac arrest is equivalent to death. In other words, a person was declared dead as soon as his heart stopped beating. This concept has changed since then and for the first time in 1961, authorities in Finland ruled that irreversible brain damage (also called brain death) is also equivalent to death. Thus, a person would be considered dead either if his heart stopped beating (cardiac death) or if his brain was totally and irreversibly damaged (brain death).

The Heart And The Kidneys

Though the heart is located in the centre of our bodies, it is not necessarily the centre of our existence. However, as far as the kidneys are concerned, the heart is a preferred organ and vice versa, The kidneys constantly strive to keep the internal chemical milieu of the body comfortable for the heart to function well. On the other hand, the heart ensures that 25 per cent of the blood it pumps outreaches the kidneys. So, there is lot of crosstalk and interaction between these two organs.

Damage to the heart causes kidney injury and damage to the kidneys causes heart injury and hence, both organs act in conjunction to protect and help each other. It is a classic example of a symbiotic relationship. Recent research has taught us that heart and kidney diseases invariably occur together and in 2011, for the first time, these disorders were given a medical name – Cardiorenal Syndrome.

The heart ensures that 25 per cent of the blood it pumps out reaches the kidneys. So there is lot of crosstalk and interaction between these two organs

There Are 5 Types Of Cardiorenal Syndromes

Cardiorenal Syndrome Type I (CRS 1)
Those with no pre-existing heart or kidney disease, new onset heart disease (also called acute heart disease) develops and leads to new onset kidney disease (also called acute kidney injury), Sudden heart attacks due to blockage of blood vessels, heart failure due to weak pumping of the heart, traumatic injury to the heart post-surgical and post anaesthesia heart disease are the usual causes of new onset heart disease which lead to kidney disease-causing CRS 1.

Cardiorenal Syndrome Type 2 (CRS 2)
People with pre-existing heart diseases like rheumatic heart disease, congenital heart disease and so on, gradually develop kidney disease over a period of time. Since the heart disease is longstanding and irreversible, the kidney disease that develops also remains irreversible and longstanding, The only recourse here is to maintain the heart and kidney as long as possible with supportive care.

Cardiorenal Syndrome Type 3 (CRS 3)
At times, new onset kidney diseases develop due to infections, medications, stones, dehydration, bleeding, trauma, etc. This can often lead to sudden onset cardiac diseases like heart attacks, heart failures and heart rhythm disturbances. This is labelled Cardiorenal Syndrome Type 3 or more descriptively, Renocardiac Syndrome Type 1.

Cardiorenal Syndrome Type 4 (CRS 4)
This is also known as Renocardiac Syndrome Type 2. Very often, patients with chronic (or longstanding) kidney disease develop heart disease. This is due to the chemical changes, toxin build-up and blood vessel damage that occurs invariably in these patients, In fact, patients with chronic kidney disease are 200 times more likely to die than normal people. And more than 80 per cent of them die due to heart-related ailments.

Cardiorenal Syndrome Type 5 (CRS 5)
Patients who have a pre-existing multisystem disease like diabetes, blood pressure, cirrhosis, vasculitis, etc. simultaneously develop both heart disease and kidney disease. The treatment here hinges on treating the primary disease which is the root cause of both the heart and kidney disorder.

Ultimately, whichever type of Cardiorenal Syndrome the patient may have, treatment depends on treating the primary cause, be it the heart or kidney or something else.

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