These past two weeks have been all about hearts, lungs, and kidneys...and a reminder of how closely they interact! While my first clinical rotation focused on specific disease states (cancer), my time on the Cardiology and Pulmonary floors showed me what a connected machine the body is.
Many of my patients had similar diagnosis groupings like heart failure, COPD, and chronic kidney disease/end stage renal disease. So after reading a few too many Dx repeats, I harkened back to my undergrad anatomy and physiology classes to pull it together. Why are these diseases so common together?
- People with hypertension may take diuretics to control their blood pressure.
- Diuretics make sodium and water leave the body, causing blood volume to decrease and blood pressure to go down.
- Blood pressure depends on:
- Forced heart contractions
- Resistance to blood flow (think hardened or clogged arteries)
- Circulating blood volume: more volume means more heart stretching. Blood volume can be altered in part by the kidneys
- COPD can be caused by smoking which also hardens arteries, increasing blood pressure. Plus, your heart has to work harder if you have COPD to support the labored breathing it causes. Just think, if your heart is working harder for you to breathe and your kidneys aren't working well either... so your heart has to work even HARDER to deal with the volume..... doesn't look so good does it?
- If your kidneys aren't functioning well, you'll need help filtering out the toxins and fluid from the body. That's where dialysis comes in! I'm currently at a Davita dialysis center this week, so expect a full on kidney update later (from the view point of someone who face plants at the sight of blood).
- Listen to your dietitian. Seriously. Dietitians aren't just telling you to eat a heart healthy diet or follow a renal eating plan because they like to hear themselves talk. All of the recomendations RDs give are to help improve quality of life and prevent more hospital visits. The recommendations are evidence based to help the patient! The whole body is connected and RDs are giving directions to make sure the body functions to its full potential.
- fluid restriction
- Vitamin K
- Hemo dialysis