Exploring the Link Between Chronic Kidney Disease and Cardiovascular Disease

CKD is a widespread condition that not only increases the risk of kidney failure but also significantly raises the risk of developing various forms of cardiovascular disease. A recent American Heart Association advisory introduced the concept of cardiovascular, kidney and metabolic disease, highlighting the complex interplay between conditions like obesity, hypertension, high cholesterol, diabetes and sleep apnea. These conditions often share overlapping risk factors and pathophysiologic mechanisms such as inflammation, oxidative stress and endothelial dysfunction, which can drive both heart and kidney damage simultaneously.

Despite CKD affecting an estimated 14% to 15% of the U.S. population (approximately 35 million people), awareness among patients remains low. Even those with advanced CKD often don’t know they have it. This lack of awareness is compounded by insufficient testing, particularly of urine protein levels, which are essential for detecting kidney damage. Guidelines recommend assessing both estimated glomerular filtration rate and urine albumin levels, but these assessments are inconsistently applied, especially among patients without diabetes. This results in missed opportunities for early intervention and a significant disconnect between laboratory evidence of CKD and formal clinical recognition through diagnostic coding.

Improved CKD detection and management are crucial not just for preserving kidney function but also for preventing cardiovascular complications. CKD is the leading cause of death among those who have it, yet its importance is often underappreciated outside of nephrology. Better integration across specialties — cardiology, endocrinology and primary care— and more holistic, risk-based care models are needed. Early recognition and timely treatment using lifestyle and pharmacologic therapies can simultaneously reduce risks to the heart, kidneys and other organs. Ultimately, shared responsibility among all healthcare providers is essential to improve outcomes for patients with CKD.