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Multiple diseases can create a vicious circle

28 September 2023

Often, kidney disease doesn’t appear on its own – frequently people are living with other health conditions too. This combination can have a huge impact on people’s lives and sadly also impact on how long they live.

For this reason helping people living with several health conditions is one of our priorities. We already fund work in this area and are accelerating progress. Here we take a closer look at heart disease and diabetes – the two biggest drivers of kidney disease – how they can impact kidney patients and what we are doing to help.

Heart disease

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.

It is regarded as a risk factor for kidney disease because the heart and kidneys work very closely together. So if something goes wrong with the heart it can also lead to problems for the kidneys.

Illustration of a person looking at a kidney and a heart

How the heart and kidneys work together

The heart and kidneys work together to maintain a healthy circulation. The heart pumps a continuous supply of oxygenated blood around the body, whilst the kidneys filter the blood and extract waste products as urine. The kidneys can only work when enough blood passes through them. The kidneys also control the amount of salt and water in the bloodstream and, by sending chemical messengers (hormones) cause arteries to contract contributing to good blood pressure control.

What happens when things go wrong? A vicious circle.

If the blood pressure is too high for a while then the heart may stop pumping efficiently (‘heart failure’). This reduces the blood supply to the kidneys, causing them to retain salt and water and send signals to increase the blood pressure even more. This causes fluid build-up and increased pressure in the main veins, which makes the heart failure worse. Heart failure can also reduce the efficiency of kidney filtration.

Many types of kidney damage cause increased production of the blood pressure controlling hormones, leading to high blood pressure. This puts an additional strain on the heart and can, in the long run, cause heart failure. High blood pressure also increases the risk of damage to the arteries, which can cause heart attacks. And vice versa, high blood pressure can damage the blood vessels in the kidney over time, damaging the filters in the kidneys (called ‘glomeruli’) and stop them working efficiently, leading to a progressive fall in kidney function.

Ways kidney patients can prevent cardiovascular disease or stop it worsening

A healthy lifestyle can help to lower your risk of getting cardiovascular disease or help to stop the condition from getting any worse. Not smoking, a balanced diet, exercising regularly, cutting down on alcohol and maintaining a healthy weight can all help.

Depending on your risk of cardiovascular disease, your GP may offer you tablets to lower harmful cholesterol in the blood (usually ‘statins’) or to lower blood pressure, or aspirin to reduce the risk of heart attacks.

One example of our work tackling heart disease and kidney disease

Two males and one female in the science lab.
The Sutherland's visiting David Long's lab

Children with chronic kidney disease (CKD) are at an increased risk of developing cardiovascular diseases (CVD) which damage their blood vessels, causing illness and even death. There is an urgent need to better understand the causes of CVD and develop new ways to treat it in these children.

Professor David Long and Rukshana Shroff from Great Ormond Street Institute of Child Health at University College London, together with PhD student Andrew White, are using a three-dimensional human blood vessel model to replicate the changes that occur in blood vessels of children with CKD. They will also develop a model that will help explore the effect of calcium and phosphate on the blood vessels, as in excess they have been linked to progression of kidney disease. Finally, they will screen drugs that can serve as therapeutic agents. It is hoped that results from this research will help to identify new treatments to protect the blood vessels of children with CKD.

This project is funded through a Sutherland studentship award.

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