This interplay can form a better understanding of why different combinations of medicines are prescribed, especially in the cardiovascular renal metabolic (CVRM) disorder landscape. 

The link between the kidneys & the heart 

The heart’s function is to supply oxygen to the organs in the body, while the kidney’s function is to filter the blood, and excrete waste products via urine. It also plays a role in the regulation of water and salt, thereby controlling the blood pressure.¹ 

Since both the heart (cardiovascular system) and the kidneys (renal system) form part of the cardiovascular renal metabolic (CVRM) disease landscape, they are interlinked with each other. This implies that abnormal functioning of either organ can lead to cardiovascular disease (CVD) and/or kidney disease. Kidney disease and heart disease share many of the same risk factors, such as diabetes and high blood pressure.¹ 

Heart failure (HF) is a significant risk factor for kidney disease. If the heart does not function properly, by pumping efficiently, it results in being congested with blood. This in turn leads to an increase in pressure to the main vein connected to the kidneys, resulting in blood congestion in the kidney as well as a reduced supply of oxygenated blood.¹ 

When the kidney’s become impaired, the hormone system which regulates blood pressure goes into overdrive in an attempt to increase blood supply to the kidneys. The heart then compensates by pumping against this higher pressure in the arteries to supply blood to the kidneys, which eventually results in kidney damage. 

Kidney and heart disease are interlinked. It is important to understand what this interplay results in. Understanding this, can create an opportunity for the pharmacist to understand the pathophysiology of the two diseases and the rationale behind the combination of medications prescribed.^1,2 

REFERENCES 

1. British Heart Foundation. Heart Matters. The heart-kidney link. Available at; https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/kidney-heart-link#:~:text=How%20they%20work%20together,levels%20to%20control%20blood%20pressure. – accessed: 08 June 2023 
2. National Kidney Foundation. The heart and the kidney connection. 2023. Available at: https://www.kidney.org/atoz/content/heart-and-kidney-connection - accessed: 08 June 2023