What is the invisible connection between the heart, kidneys, and metabolism? An art exhibition reveals it.

Approximately one in three adults worldwide suffers from several chronic diseases, including chronic kidney disease (CKD). In Spain, the prevalence of CKD is 15.1% (i.e., one in seven adults suffers from CKD). However, as the disease is often asymptomatic in its early stages, it is estimated that two out of three people with CKD remain undiagnosed. Diabetes also affects nearly 5 million patients in Spain. Heart failure (HF) affects approximately 800,000 adults in the country. All of these are some of the diseases that make up the cardiovascular-renal-metabolic syndrome.

With the aim of connecting emotionally with the public and raising awareness about the complex connection between these three systems, as well as highlighting the importance of early detection, Boehringer Ingelheim has launched the "Invisible Connections" campaign in collaboration with the Hospital Clínic Barcelona and the University Hospitals of La Paz (Madrid) and Virgen de la Victoria (Málaga).

Through a captivating fusion of art and health, renowned illustrators Jordi Labanda, Ricardo Cavolo, and Ana Jarén present three large-scale works that pay homage to key organs in the cardiovascular, renal, and metabolic systems. With their distinctive style, each artist visually interprets the complexity and significance of the interaction between these systems. Barcelona hosts the work dedicated to the kidney, an organ linked to chronic kidney disease. In Madrid, the organs linked to metabolism—the liver and pancreas—take center stage, reflecting the challenges of diseases such as type 2 diabetes (T2DM), metabolic dysfunction-associated steatohepatitis (MASH), and obesity. Finally, Málaga becomes the stage for the heart, linked to heart failure.

Art is emerging as the ideal medium to raise awareness among citizens about the importance of early diagnosis through the detection of risk factors associated with comorbidities; and also to highlight that comprehensive and coordinated care that addresses these diseases in a multidisciplinary manner is essential to combating them.

The objective of the proposal is to raise awareness about the interconnection between different pathologies, as well as the need for early detection, a holistic approach and integrated care that addresses these diseases together.

Furthermore, as part of the campaign, some of the aforementioned hospitals held triangular roundtable discussions, in which healthcare professionals, health authorities, and representatives of patient associations jointly addressed the importance of a thorough understanding of cardiovascular-renal-metabolic syndrome.

A holistic approach

As Dr. Aleix Cases, Senior Consultant in the Nephrology Department at Hospital Clínic Barcelona, ​​explains, “Chronic kidney disease is a common condition. Up to one in seven adults in Spain may suffer from it. However, many patients are unaware that they have it, as it can progress without symptoms for years. Detecting it early would not only halt or slow its progression, but also prevent the cardiovascular and metabolic complications that are often associated with it. To diagnose it, two simple and accessible medical tests are crucial: measuring albumin and creatinine in a urine test (as an indicator of kidney damage) and measuring the estimated glomerular filtration rate (eGFR), a calculation based on blood creatinine levels (as an indicator of kidney function).” Performing these tests is essential because CKD often does not present symptoms until its advanced stages.

The close relationship between cardiovascular, kidney, and metabolic diseases requires a holistic approach that considers a person's health as a whole. When a person suffers from a condition affecting one of these systems, the likelihood of other systems being affected increases; a fact that is not widely known among the population. Thus, the Interconnected Barometer confirms that approximately 60% of Spaniards are unaware of the relationship between chronic kidney disease, type 2 diabetes, and heart failure.

This interconnectedness means that these diseases coexist, progress, and amplify each other, resulting in a significant impact on patients' lives. For example, cardiovascular mortality accounts for between 40% and 50% of all deaths in patients with advanced CKD. Furthermore, all of this has a significant impact on healthcare systems: In Spain, renal replacement therapy accounts for almost 3% of healthcare expenditure in the Public Health System and 4% of that in Specialized Care.

Despite the similarities between the various conditions, recommendations, guidelines, and care processes still tend to be segmented by pathology. As a result, the care pathway is often fragmented, creating a barrier for patients, who are forced to coordinate numerous appointments with different specialists.

According to the Interconnected Barometer, 60% of Spaniards are unaware of the relationship between chronic kidney disease, type 2 diabetes, and heart failure.

Without a doubt, it is essential to commit to comprehensive and coordinated healthcare management that encompasses both primary and hospital care. Improving the resources available in the former is one of the challenges that health experts in Spain consider key to better care for chronically ill patients.

For all the reasons explained above, campaigns like these seek to prioritize cardiovascular, renal, and metabolic pathologies in healthcare plans and develop strategies to promote collaboration within the healthcare ecosystem. Actions like "Invisible Connections" are an invitation to reflect on a problem that often remains hidden. At the same time, as Román Bartomeo, Director of Corporate Affairs at Boehringer Ingelheim in Spain, points out, the exhibition is evidence of this healthcare company's commitment to "expanding knowledge about the connection between the cardiovascular, renal, and metabolic systems, as well as making early diagnosis available to more and more people."

To achieve this, Bartomeo adds, "we believe it is important to ensure greater coordination between the different stakeholders in the healthcare system, coordinated and integrated care across different levels of care and across different healthcare professionals." Only in this way can we contribute to identifying needs and implementing policies that offer comprehensive solutions and promote a more effective and early approach to chronic patients.