World Heart Day: Why Cardiologists Are Talking About Kidneys

Today is World Heart Day, and Eugene Wright Jr., M.D., a private practitioner, academic clinician and educator who serves as a consulting associate in the Department of Medicine at Duke University Medical Center, wants people to understand a connection that often gets overlooked: The heart and kidneys depend on each other to function properly. The kidneys filter toxins from the blood and help regulate blood pressure, while the heart controls the blood flow and pressure that keep the kidneys working. When one organ is under strain, Wright said, it frequently shows up in the other.

That relationship matters because the kidneys can act as an early warning system. Wright said kidney function can signal ongoing damage in the cardiovascular system well before a cardiovascular event, such as atherosclerotic disease or heart failure, occurs.

Two tests, two different signals

Wright pointed to two tests that reveal what’s happening in the kidneys. The estimated glomerular filtration rate (eGFR) measures how effectively the kidneys filter waste from the blood. Wright compared it to a phone battery: An eGFR of 90 or above means the kidneys are operating at close to full capacity, while an eGFR of 45 means they’re working at roughly 45%. An eGFR under 60 signals the possibility of kidney disease.

The second test, the urine albumin-to-creatinine ratio (uACR), checks for albumin, a protein that shouldn’t normally show up in urine in meaningful amounts. Wright said detecting that protein early is a sign of kidney filtering problems and stress on the system. The uACR is a simple urine test that can be run in a doctor’s office or sent to a lab.

A test that reveals more than kidney disease

For years, uACR was seen mainly as a predictor of chronic kidney disease. Wright said research has since shown it’s also an independent signal of cardiovascular risk. Rising urinary albumin levels are associated with a 69% higher risk of a cardiovascular event such as a heart attack or stroke, a 1.5-times higher risk of heart failure, and a 57% higher risk of dying from a cardiovascular event. That data has helped clarify the bidirectional relationship between the heart and kidneys, Wright said, and shown that treating one condition can improve the other.

Detect the SOS

Wright’s comments tie into Detect the SOS, a public health campaign led by Boehringer Ingelheim alongside a coalition of health organizations, advocates, patients and caregivers, aimed at raising awareness of uACR testing, particularly among people with Type 2 diabetes or high blood pressure, two of the leading risk factors for chronic kidney disease.

How to start the conversation with your doctor

Wright pointed to resources designed to help patients raise the subject with their care team. The American Heart Association’s guide outlines a “3 Cs” framework for a short conversation: Connect (“How are my heart, kidneys and metabolic health affecting each other?”), Check (“What stage of CKM syndrome am I in, and what do my numbers mean?”), and Customize (“What change would make the biggest difference for me right now?”). The Detect the SOS website also offers sample scripts, including simply asking, “Since we're already talking about testing, I’d like to add my uACR test to help assess my heart and kidney health.”

Wright also pointed to the AHA’s patient resource guide to the 2026 Cardiovascular-Kidney-Metabolic (CKM) Syndrome clinical practice guideline, and to additional educational material at detectthesos.com.

A partnership between patients and providers

Wright said addressing heart, kidney and metabolic health together requires patients to see themselves as active partners in their care, informed and engaged, while clinicians stay empathetic and genuinely listen to patients’ concerns.