In chronic heart failure can your kidneys suddenly get a lot worse even though the echocardiogram says your cardiac functioning has been stable for several years?

Decompensation means a sudden or abrupt worsening of function. The term decompensation is usually used for the heart, but can also pertain to the liver and kidneys.

This is for those who wonder if the following scenario is realistic for men and women with chronic heart failure with the same ejection fraction for the past few years – including ejection fractions in the 40s.

• Instead of a sudden worsening of cardiac function injuring the kidneys, the cardiac function remains stable – but the kidneys one day decide to give up the good fight and go south.

• And if both kidneys suddenly decide to give up the good fight, how is it that this occurs to both at the same time rather than one at a time?

“Yes, that’s possible,” says Roger Mills, MD, cardiologist and former professor of medicine, University of Florida, and author of “240 Beats per Minute. Life with an Unruly Heart.”

“Fortunately, it’s not very common. Remember, that heart failure patients usually have other diseases as well.”

Kidney Injury Scenarios in Chronic Heart Failure

#1. “The urinary tract is obstructed,” says Dr. Mills.

“This means that the problem lies somewhere between the kidney and the outside world in the ureters, bladder or urethra.

“Heart failure patients may have kidney and bladder stones, urinary or other abdominal tumors, etc.

“Although relatively infrequent, obstruction should be the first thing to consider because dealing with it is often a straightforward problem.”

#2. “The kidneys have been exposed to a potential toxin.

“Some drugs, notably some antibiotics, have the potential to cause renal injury. Some 15-20% of heart failure episodes are precipitated by pneumonia, so heart failure patients often receive antibiotics.

“Non-steroidal anti-inflammatory drugs can also impair kidney function, and because they are available over-the-counter, patients think they are safe.”

#3. “The kidneys have experienced a serious reduction of blood flow.

“Perhaps during surgery, or as a consequence of gastrointestinal blood or fluid loss, or as a result of serious infection, renal blood flow falls and acute kidney injury is the result.”

Why Would Both Kidneys Decompensate at the Same Time?

Dr. Mills explains, “As a rule, both kidneys share a similar environment, so they respond in the same way to insults.

“If just one kidney has reduced blood flow or is obstructed, the other will often function well enough to stave off disaster.”

Best Thing You Can Do for Your Kidneys

  • No, it’s not take a particular supplement.
  • It’s not some kind of periodic cleanse or herbal tea.

The best thing you can do for your kidneys is to take care of your heart!

One-fourth of the heart’s blood output goes to your kidneys. One look at a vascular anatomy diagram will make this obvious.

A heart that pumps very efficiently will mean plenty of blood to the kidneys.

Though the kidneys can be adversely affected by agents unrelated to cardiac output, the fact remains that chronic heart failure is very dangerous to these organs.

Dr. Mills also recommends to “avoid everyday use of over-the-counter pain medications like acetaminophen (Tylenol) and the nonsteroidal anti-inflammatory drugs, NSAIDs, like ibuprofen and indomethacin. Excessive exposure to these drugs can cause kidney damage.”

Chronic heart failure does NOT have to be an inevitable consequence of aging, especially since many patients are under age 65.

Be heart smart: exercise, have a plant based diet, control blood pressure and avoid tobacco!

dr. mills

Dr. Mills is the former medical director of the heart failure and heart transplant service at the University of Florida, was a staff cardiologist at The Cleveland Clinic and has authored over 100 peer-reviewed publications.