Multiple Organ Failure is All Related by the Same Mechanisms

Now we know how to avoid it.

The picture above is of a normal liver on the left and a liver with cirrhosis on the right. It shows what happens in all organ failure. The liver on the right is smaller because the functional liver cells have died and they have been replaced by scar tissue. That is the way all organ failure due to obesity, diabetes, and related conditions occurs.

Liver disease is a frequent problem in overweight people. Around 70% to 90% of individuals with obesity have fatty liver not due to alcohol. In the general population 25-30% have fatty liver. The next stage of this type of liver disease is hepatitis with inflammation, injury, and death of some of the functional cells of the liver (hepatocytes). Scar formation occurs simultaneously due to the repeated injury and repair. Over years this process leads to cirrhosis of the liver with extensive and irreversible scarring. Liver failure occurs in the late stages of cirrhosis. Cirrhosis that stems from obesity and insulin resistance has become the second leading and fastest-growing cause of liver transplantation.

Kidney disease is very much like liver disease. The progression of damage in the kidney due to chronic conditions like diabetes and hypertension is very similar to what happens in the liver. The functional cells are damaged and lost, and replaced by scar tissue, ultimately leading to organ failure and shrinkage. In both the liver and the kidney obesity, diabetes, and hypertension may cause the functional cells in the organ to sicken and die followed by repeated replacement with scar tissue.

The same thing happens in the brain. As in the case of liver and kidney failure due to obesity, diabetes, and hypertension, the functional cells in the brain die and the brain shrinks in degenerative diseases including alzheimer’s disease and other dementias. Unlike liver or kidney cells, neurons (nerve cells) in the adult brain generally do not regenerate. In neurodegenerative diseases like AD, there is a progressive and widespread loss of neurons. These cells in the liver, kidney, and brain die from the same thing— stress induced by excess oxidant production, inflammation, and metabolic dysfunction The fundamental theme of chronic disease progression leading to decreased organ function and eventually shrinkage due to the replacement of functional tissue by non-functional scar tissue holds true across these organs.

This shared principle underscores that chronic insults (metabolic, inflammatory, oxidative) can lead to a similar result organ failure characterized by a reduction in the cells that provide organ function leading to shrinkage of the organ. As we have discussed in the last several posts obesity and excess abdominal fat increase oxidant production which activates mTOR and deactivates AMPK. mTOR activation leads to programmed cell death of the functional cells in these organs and stimulates the growth of scar tissue.

These same principles apply to organ damage in the heart and lung. The damage to all major vital organs from obesity, diabetes, and related diseases is related. It involves the same nutrient and growth factor pathways we have been reviewing. Understanding those root causes leads to an obvious conclusion.

You can protect the health of those vital organs and stay healthier longer by getting some exercise, eating whole real food (Mediterran diet), and using losartan or lisinopril for high blood pressure, statins for high cholesterol, and metformin or Jardiance for type 2 diabetes. It is not any one thing that helps you live a longer, healthier life. By following rational comprehensive strategy based on the latest scientific evidence, you can live a longer healthier life with modest effort.

We already have evidence that this approach works. People with type 2 diabetes who already have chronic kidney disease and an average age of 55 are very high risk individuals. Most of them don’t live long enough to go on dialysis because they die of heart attack and stroke. If you compare best practice medical treatment or optimal medical therapy (OMT) with usual care— the care that most of us receive, over a 21 year period, the differences are astonishing. By age 68, half of the usual care patients were dead. Patients in usual care were six times more likely to need dialysis because of kidney failure. They were four times as likely to have a heart attack and five times as likely to have a stroke. They were 70% more likely to be hospitalized with congestive heart failure. Patients on best practice medical treatment lived 8 years longer free of heart attacks and strokes. There is really no comparison and now we understand why there is a difference very well. Let’s work together to be sure that you receive these benefits.