The relationship between heart and kidney health—and sometimes between cardiologists and nephrologists—can be fraught. “The struggle is that there's very complicated pathophysiology happening and it's a little bit like a marriage or a relationship, where if one person's unhappy, the other person tends to be unhappy as well,” explained Jacob Stevens, MD, FASN, an assistant professor of nephrology at Columbia University Irving Medical Center in New York City. However, Stevens and other clinicians across the United States are working to improve the care of patients with heart and kidney diseases and close the gap between specialties by building cardiorenal services or clinics. During the “Nephrocardiology Care Models: From Idea to Implementation” session at Kidney Week 2023, Stevens and three other presenters shared how several institutions provide nephrocardiology (also known as cardiorenal or cardionephrology) care.
The session occurred amidst growing recognition of the need for multidisciplinary care for patients with cardio-renal-metabolic diseases, including a recent presidential advisory from the American Heart Association (AHA) (1), which was co-authored by Janani Rangaswami, MD, section chief of nephrology at the Washington, DC, Veterans Affairs Medical Center and professor of medicine at The George Washington University School of Medicine and Health Sciences, who co-moderated the session at Kidney Week. Session presenter Nisha Bansal, MD, FASN, professor of medicine in nephrology at the University of Washington (UW) in Seattle, noted that there has also been increasing calls from within the nephrology field over the past 5 to 10 years to increase kidney-cardio care specialization.
“Interdisciplinary care models were highlighted [in the AHA advisory] as a critical need to actually achieve the goals of managing cardio-kidney-metabolic disease,” Bansal said. “Given the call from nephrology, as well as now cardiology, I do think the time is now to think about how to move nephrocardiology care forward.”