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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 McCuilough, preventive medicine chief at Michigan's William Beaumont Hospital. "The average patient has no idea of 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.4 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.5

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.6 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 all8，high blood pressure and diabetes are chief risk factors for both chronic kidney disease and heart attacks. But the link goes beyond9 those risk factors，stresses McCuilough： 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. ” McCuilough and colleagues tracked more than 37,000 relatively young people 一 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 urine; 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 years, mostly from heart problems. "This study is very much a wake-up call," McCullough says.

注释：

1.keep a close eye on:密切地关注

2.All it takes are urine and blood tests that cost less than $25，something proponents want to become as routine as cholesterol checks.这种对缓慢形成的肾病的早期诊断所采取的全部措 施就是尿检和血检，其费用不足25美元，提出这项建议的人希望它能像胆固醇检查那样成 为一种常规检查。本句中，it takes是all的定语从句，something是urine and blood tests的 同位语，proponents want to become as routine as cholesterol checks 是 something 的金语从句。

3.have no idea of:没有……的概念,不知道……

4. 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.肾脏如此缓慢地丧失它从i流中—出废物 的能力，以至于直到该器官受到严重损伤时才有明显症状。not... until:直到……才……。

5.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.终末期丨肾衰竭病人数目迅速 增加，有40万人需要肾透析或肾移^[才能存话，这个数字在近20年中每10年翻一番。 end-stage kidney failure??终末期肾衰竭。a toll 是 400,000 people requiring dialysis or a transplant to survive 的同位语。

6. 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.尽管慢性肾病患者常常 害怕不得不去做肾透析，但是严酷的事实是，大多数人在肾脏还没有那么糟糕以前就死于 心脏病，这一点肾病专家几年前就已经知道，只是不被广为人知而已。这里，something是 the hard truth is... to that point 这个句子的同位语，后面的 kidney specialists have recognized for several years but isn't widely known 则是 something 的定语从句，省略了关系代词 that。

7. 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.其实，这项新的研究在本月的《内科档案》杂志上就受到重视，该研 究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，并要更好地关注早期肾病Q她dici/ie:《内科档案》。call for：要求，号召，提倡。check out:检验。

8.after all:毕竟

9.go beyond:超过

10.in turn:依次

11.glomerular /glD'merjub/ filtration rate (GFR)：肾小球滤过率

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