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Understanding the link between heart, kidney

Olivia Olarte-ulherr/senior Reporter
Filed on April 27, 2015

When one organ is failing, the other organ fails and it becomes a very vicious loop, says expert.

Abu Dhabi - A new revolutionary approach to treating heart and kidney diseases has the potential to save lives, but this requires a shift in thinking and interdisciplinary approach which may prove to be a challenge for some specialities.

Understanding the link between heart, kidney (/assets/oldimages/rabb2504.jpg)According to Professor Hamid Rabb, vice-chair of the department of medicine and director of kidney transplant at Johns Hopkins University in the US, organ damage — particularly damages to the heart and the kidney — used to be looked at separately in the past.

“But what is being recognised ... is that frequently when one organ is failing, the other organ fails and it becomes a very vicious loop. The current treatment that we have, if you look at one organ by itself, is insufficient and people frequently get ... sicker and many die.

“There’s a new scientific approach that has been led by people in Europe and America and they are starting to look at when an organ fails ... They are looking at it as a new syndrome, and they’re looking at the science of this to improve the patient outcomes.”

This is known as the cardio-renal syndrome, when both the heart and kidney aren’t working, he said. Professor Rabb presented a lecture on this subject at the two-day Burjeel Medicine Update Conference held last week.

Speaking to Khaleej Times on the sidelines of the conference, Professor Rabb explained that when treating someone with a heart failure, the attempt to treat the heart sometimes results in kidney failure. In a patient with kidney failure, while he/she is being sustained by dialysis or transplant, that patient, however, is “dying from heart disease.”

“You cannot just look at each organ failure by itself, you have to look at the whole body, how the kidney and the heart talk to each other,” he said. “It’s a new classification, a new disease entirely, (we need) to do research on it to understand it. We can develop new treatments to improve the outcomes and decrease the suffering and increase the longevity of these patients.”

This means specialists have to work together. “In the past you have the heart specialist and kidney specialist, each of them is doing their best but they get stuck in the final management.”

New way of thinking

“It is a new field ... this is a new approach to create this disease system and a new way of classification of the disease ... (but) it requires a new way of thinking in an interdisciplinary way. Doctors have to now approach things more as a team rather than traditional specialties,” Professor Rabb said.

“The kidney doctors needs to be as cognisant of the heart issues, as the kidney issues, and similarly, when a patient has heart failure, the heart doctor and the internist have to look closely into the kidney or else they will not get the outcome that they desire.”

But this is easier said than done, as this “requires a shift in the way of training, in the way of thinking and ... people have to think in a new way, which is the way of the future. If one wants to have the optimal outcome, one has to change one’s thinking,” he stressed.

He noted that the cardio-renal syndrome is still in its early phases. This definition only came about in 2008 and in 2015, it is starting to get popular.

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