CardioSource WorldNews August 2015 | Page 33

In health, the relationship between the kidneys and the heart reveals itself to be one of mutual interdependence. Up to one quarter of cardiac output goes straight to the kidneys, and, in turn, the kidneys play an important role in electrolyte balance, protein production, and blood pressure regulation. However, when things go south health-wise, this relationship can quickly become codependent—a term defined by the American Heritage® Dictionary as “mutually dependent…in an unhealthy way” or broadly (by Merriam-Webster’s Dictionary) as “dependence on the needs of or control by another.” In our example, dysfunction in one organ supports or enables the dysfunction of the other organ, and it’s frankly hard to know which organ to blame for what. O ne factor complicating this issue: many cardiologists and nephrologists don’t enjoy any relationship at all—not dependent, interdependent, or codependent. Cardiac-focused clinical trials often exclude patients with significant kidney disease and practice guidelines don’t provide great guidance on how to best manage these patients. However, our organs didn’t get the memo on this artificial divide, leaving cardiologists scrambling ›X[