Heart disease and chronic kidney disease (CKD)

red heart stethoscope

Having chronic kidney disease (CKD) means you are more likely to get heart disease. CKD can cause heart disease, and heart disease can cause CKD. In fact, heart disease is the most common cause of death among people on dialysis. 

The best way to prevent heart disease is to prevent or treat the problems that can cause it, such as diabetes, high blood pressure and anemia.


red blood cells graph

What is heart disease?

Heart disease includes any heart or blood vessel problem that keeps your heart from pumping blood as well as it should. It is also called cardiovascular disease (CVD).

Heart disease can include:

Coronary artery disease (CAD)
A blood clot that blocks the flow of blood to your heart
Heart attack
Problems with your heart's muscle, valves or heartbeat

If your kidneys do not work well, they cannot support other parts of your body as well as they should. This causes problems with tissues and other organs, including your heart.

What are the symptoms of heart disease?

You may not have symptoms of heart disease until your heart and blood vessels are badly damaged. Symptoms depend on the type of heart disease you have. 

Symptoms of heart disease include:

  • Chest pain
  • Shortness of breath
  • Feeling sick to your stomach
  • Feeling weak and tired
  • Pain, numbness, weakness or coldness in your legs or arms
  • Pain in your neck, jaw, throat, upper belly area (abdomen) or back
  • Swelling of your legs, ankles and feet
  • Irregular heartbeats that feel fast, pounding or fluttering
  • Feeling dizzy or lightheaded or fainting

Tell your doctor if you feel symptoms because heart disease is easier to treat when it is caught early.

What causes heart disease?

Diabetes and high blood pressure, the most common causes of CKD, also cause heart disease. 

Diabetes is a lifelong disease where too much sugar stays in your blood because your body cannot make or use insulin, the hormone that turns blood sugar (glucose) into energy. High blood sugar can damage blood vessels in the kidneys and the heart.

High blood pressure is a condition where the force of blood in your blood vessels is too strong, which can damage your heart and the blood vessel walls. If your kidneys do not work well, your hormone system makes the heart pump harder to increase the blood supply to your kidneys. This raises your blood pressure. 

Other health problems that can happen with CKD and cause heart disease include:

  • Anemia
  • High homocysteine levels, which is a protein that builds up in your blood if damaged kidneys cannot remove it — this can damage blood vessels or lead to a heart attack
  • Unbalanced calcium and phosphorous levels

Talk to your doctor about being tested for diabetes, high blood pressure and problems that can happen with CKD.

How will I know if I have heart disease?

If you have CKD, your doctor will do regular checks for signs of heart disease, including physical exams and asking you about symptoms.

If you have any symptoms of heart disease, your doctor will do tests, such as:

Your doctor will do different tests depending on what type of heart disease they think you may have.

How do doctors treat heart disease?

If you have heart disease and CKD, your doctor may prescribe medicines to treat your heart disease.

Medicines to treat heart disease include:

  • Diuretics (water pills): Medicines that lower blood pressure, remove extra fluid and help your kidneys get rid of water and salt.
  • Ace inhibitors: Heart medicines that widen your blood vessels, lower blood pressure and improve blood flow.
  • Beta blockers: Medicines that lower blood pressure by blocking the hormone adrenaline, which helps your heart beat more slowly and with less force.

Some of these medicines may cause problems with your kidneys. Talk to your doctor about which medicines could work best for you. 

Your doctor will also encourage you to make healthy life changes, such as to be active and eat kidney-friendly foods. They can help you find a dietitian to create a healthy eating plan.

How can I prevent heart disease?

The best way to prevent heart disease is to work with your doctor to find and treat the problems that can lead to heart disease, such as diabetes, high blood pressure and anemia.

You can also help prevent heart disease by making healthy life choices, including to:

  • Eat kidney-friendly foods that are low in salt and fats
  • Take your medicines exactly how your doctor told you
  • Be active most days of the week to help lower blood pressure and improve blood flow, such as walking, biking or swimming
  • Quit smoking, if you smoke
  • Lower stress by learning ways to relax such as calm breathing, yoga or meditation 

Ask your doctor about other ways to lower your chance for heart disease if you have CKD.