BRINGING A WIDER LENS TO OUR MEDICAL VIEW| FRESENIUS MEDICAL CARE
Dragonflies can see everything, all the time, all around. They have so many lenses on their headthat nothing gets by them.When they seea predator approach, theycanreact in a fraction of a second.I wish I had the eyes of a dragonfly.
Sevenyears ago, my life required saving and I didnĢýt even know it.
At that time, I was only 52 years old, adoctor for 27 years andarespected voice in my field. Considered healthy byallaccounts,I waslying on an examtablewatching my heart on a monitorduring a routine evaluation that millions of Americans get every year.
Because of my experience,I knew that the obstructed blood vessel on the monitor would require a serious procedure. Soon after, Iunderwentheart surgery.
As a practicing kidney doctor, I have seen thousands of patients. I have explained the risks of ĢýsilentĢý kidney disease that could lead to a life of dialysis to many. But how often had I missedthe signs ofsilent cardiac disease like my own?
It made me think of my own medical vision Ģýor lack thereof. I wassomehowunable to lookbeyond what was righttherein front of me. But what ifI could see my entire health view like a dragonfly. What ifour medical systemas a wholecouldsee the big picture?
The body is much greater than the sum of its parts. Yet health professionals often look at things in terms of independent organs or disease processes.
Systemic diseases do not play by those rules. Comorbid conditions, the presence of more than one disease, can appear in as much as 25 percent of the population, according to a 2010 study by the Centers for Disease Control and Prevention.
As medical professionals, we need to improve our ability to view patientsĢý complete health Ģý otherwise we risk missing a host of interacting disorders.
A prime example is kidney and cardiac disease. A number of studies have shown that cardiac disease is the biggest killer among patients on dialysis, accounting for 20 to 30 percent of deaths.
In our medical office, we are finding new ways to predict comorbidities through data, identifying patients at risk and ensuring our full view of their care is accurate. We are even looking at ways to predict complications and potential hospitalizations by allowing computers to read a nurseĢýs notes.Ģý
Meanwhile, new genomic and proteomic tests hold the promise to help us better predict disease, and find the targeted treatments needed for improving outcomes. Can we help our patients with kidney failure avoid further complications from certain medications by better understanding their genomic profile? We must try and unlock the unique nature of each individual and respond with thoughtful therapies.
When new simple predictive tests come alongthat are proven effective, we need to adopt them.Astudy by Johns Hopkins University showedthat a simple blood and urine test used to identify people with kidney issuescan also accurately predict anincreased risk for heart and vascular disease.The U.S. Preventive Services Task Force should recommend aggressive screening with these simple tests for all adults.
Finally, we need to train physicians to spot the links between kidney, heart disease and related chronic conditions, as well as complete further research into these links.
We should not let heart disease sneak up on our patients like it did to me. We need more active surveillance to link systemic conditions. ItĢýs time to takewhat welearn from the dragonfly andapply it to medicine. A360-degreeview can save lives.
Franklin W. Maddux, MD, FACP
Chief Medical Officer
EVP of Clinical and Scientific Affairs
As we recognize American Heart Month in February, itĢýs important to understand the tight relationship between the kidneys and the heart. A growing body of research has documented the way kidney disease can trigger or worsen heart disease and how heart disease can destroy the kidneys. Learn more about the relationship in Ģý.ĢýĢý
