Kidney Disease and Heart Disease Spur Each Other
Hearts and kidneys: If one’s diseased, better keep a close eye on1 the other. Surprising new research shows kidney disease somehow speeds up heart disease well before it has ravaged the kidneys. And perhaps not so surprising, doctors have finally proven that heart disease can trigger kidney destruction, too.
The work, from two studies involving over 50,000 patients, promises to boost efforts to diagnose simmering kidney disease earlier. All it takes are urine and blood tests that cost less than $ 25, something proponents want to become as routine as cholesterol checks. 2 “The average patient knows their cholesterol,”says Dr. Peter McCullough, preventive medicine chief at Michigan’s William Beaumont Hospital. “The average patient has no idea of3 their kidney function.”
Chronic kidney disease, or CKD, is a quiet epidemic: Many of the 19 million Americans estimated to have it don’t know they do. The kidneys lose their ability to filter waste out of the bloodstream so slowly that symptoms aren't obvious until the organs are very damaged. End-stage kidney failure is rising fast, with 400,000 people requiring dialysis or a transplant to survive, a toll that has doubled in each of the last two decades, s
And while CKD patients often are terrified of having to go on dialysis, the hard truth is that most will die of heart disease before their kidneys disintegrate to that point, something kidney specialists have recognized for several years but isn't widely known, s Indeed, the new research is highlighted in this month's Archives of Internal Medicine with a call for doctors who care for heart patients to start rigorously checking out the kidneys, and for better care of early kidney disease. 7
The link sounds logical. After alla , high blood pressure and diabetes are chief risk factors for both chronic kidney disease and heart attacks. But the link goes beyond" those risk factors, stresses McCullough: Once the kidneys begin to fail, something in turn10 accelerates heart disease, not just in the obviously sick or very old, but at what he calls “a shockingly early age.” McCullough and colleagues tracked more than 37,000 relatively young people―average age 53 ― who volunteered for a kidney screening. Three markers of kidney function were checked: The rate at which kidneys filter blood, called the GFR or glomerular filtration rate11; levels of the protein albumin in the urinei and if they were anemic. They also were asked about previously diagnosed heart disease.
The odds of having heart disease rose steadily as each of the kidney markers worsened. More striking was the death data. At this age, few deaths are expected, and indeed just 191 people died during the study period. But those who had both CKD and known heart disease had a threefold increased risk of death in a mere 2 1/2 years, mostly from heart problems. “This study is very much a wake-up call,” McCullough says.
练习：
1. How can one learn earlier whether he or she suffer simmering kidney disease?
A By cholesterol checks.
B By urine and blood tests.
C By keeping a close eye on one's kidneys.
D By measuring the volume of urine output.
2. How many Americans suffer chronic kidney disease according to an estimation?
A 1,9,000,000.
B 400,000.
C 50,000.
D 37,000.
3. How many Americans suffered end-stage kidney failure and required dialysis or a transplant to survive twenty years ago according to an estimation?
A 400,000.
B 300,000.
C 200,000.
D 100,000.
4. What did the Archives of Internal Medicine call for doctors caring for heart patients to do?
A To examine their patients' heart function carefully.
B To have their patients' chests X-ra Yed regularly.
C To select volunteers from their patients for a kidney screening.
D To start rigorously checking out their patients' kidneys.
5. Which of the following is NOT one of the three markers of kidney function?
A Levels of the protein albumin in the urine.
B Levels of the white blood cells in the blood.
C The rate at which kidneys filter blood.
D Whether one is anemic or not
答案与题解：
1.B 第二段第一、二句说到，加速慢性肾病的诊断所使用的方法就是尿检和血检，故B项为正确答案。
2.A 第三段第一句说。在估计患有慢性肾病的1，900万美国人呼叫很多人不知道自己患此病，可见A项是正确答案。
3.D 第三段最后一句说.终末期肾衰竭病人数日迅速增加，有40万人需要肾透析或肾移植才能存活.这个数字在近20年小每10年翻一番。按此计算，10年前应为20万人，20年前就应是10万人，故正确答案应为1)。
4.D 第四段最后一句说到，《内科档案》杂志号召为心脏病人治病的医生要开始严格地检查病人的肾脏，D项正是它要求做的事情。
5.B 第五段倒数第二句列㈩了肾功能的三个标志物.选项C、A、D均包括在内，唯独没有B项，故B项是本题答案。
