Chronic kidney disease and heart failure--Bidirectional close link and common therapeutic goal

Chronic kidney disease (CKD) is common and the estimated prevalence is about 9-13% in the general adult population. CKD is defined by the presence of kidney damage or decreased glomerular filtration rate. Individuals with CKD have a far greater likelihood of cardiovascular death than progression to end-stage renal disease. Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder and the prevalence is reported to be 2-3% in the general population. The prognosis of HF patients is still poor despite recent advances in HF treatment. Both diseases are major and growing public health problems because aging of the population contributes to the increasing incidence of those diseases. More than 40% of HF patients have CKD and the close relationship between CKD and HF worsens their prognoses. All physicians must evaluate kidney function using estimated glomerular filtration rate calculated by the new Japanese equation in patients with HF. Accurate evaluation of pathophysiology between the two diseases and appropriate intervention are necessary to improve the prognosis of patients with the diseases.