Chronic Kidney Disease Fuels Heart Trouble – and Heart Trouble Worsens Kidneys! A Dangerous Cycle You Need to Know.”

• CKD Accelerates Atherosclerosis: Chronic Kidney Disease (CKD) contributes to faster atherosclerosis development through multiple mechanisms.
• Cardiorenal Physiology & Heart Failure: The complex interaction between the heart and kidneys complicates heart failure (HF) and its management.
• High Cardiovascular Death Risk in Dialysis Patients: Studies show that patients on dialysis have a 30-fold higher risk of dying from cardiovascular disease (CVD) than the general population.
• Increased CVD Prevalence in CKD Patients:
• • 63% of CKD patients in the U.S. have cardiovascular disease.
  • In contrast, only 8% of non-CKD patients have CVD.
• Heart Failure (HF) is a Major Risk for CKD Patients
  • HF is the most common cardiovascular complication in CKD patients.
  • As kidney function declines, the risk of HF increases.
• Challenges in Treating HF in CKD Patients
  • HF in CKD patients often presents differently, mainly as HF with preserved ejection fraction (HFpEF).
  • Many clinical trials exclude patients with advanced CKD, making treatment guidelines unclear.
• How CKD Complicates HF
  • Poor kidney function leads to reduced blood flow to the kidneys.
  • Pre-existing kidney disease worsens HF.
  • Medications for HF can sometimes harm the kidneys.
• Recommended Treatments for CV Risk in CKD Patients
  • Renin-Angiotensin-Aldosterone System (RAAS) inhibitors help manage cardiovascular risk in CKD.
  • SGLT2 inhibitors, originally for diabetes, have been found to improve both heart and kidney health by reducing cardiovascular and kidney-related complications.

SGLT-2 receptors in the early proximal tubule reabsorb 90% of filtered glucose.

SGLT-1 receptors handle the remaining 10% of glucose absorption.

Benefits of SGLT-2 Inhibitors

Help control blood sugar without increasing the risk of hypoglycemia. Work independently of insulin secretion.

Impact on Diabetes and Heart Health

Clinical trials indicate that SGLT-2 inhibitors decrease mortality and cardiovascular (CV) events in patients with diabetes. Interestingly, they also reduce the risk of heart failure (HF) among these patients.

Role in CKD and Heart Failure

Studies confirm SGLT-2 inhibitors improve outcomes for both CKD and HF. They are equally effective in patients with and without diabetes, proving the strong kidney-heart connection.