Cardiovascular-Kidney-Metabolic Syndrome: A New Paradigm in Clinical Medicine or Going Back to Basics?
Victoria Mutruc1,2, Cristina Bologa1,2, Victorița Șorodoc1,2
1Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
Cardiovascular-kidney-metabolic (CKM) syndrome links heart, kidney, and metabolic diseases. Understanding their interdependence is key for integrated management to improve patient outcomes and reduce health burdens.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
- Metabolic Diseases
Background:
- Cardiovascular, renal, and metabolic diseases are interconnected, increasing global morbidity and mortality.
- The American Heart Association (AHA) defined this network as cardiovascular-kidney-metabolic (CKM) syndrome in 2023.
- Common pathophysiological mechanisms include inflammation, oxidative stress, insulin resistance, and RAAS activation, creating a detrimental cycle.
Purpose of the Study:
- To review the complex interactions between cardiovascular, renal, and metabolic systems.
- To synthesize information on diagnostic approaches for CKM syndrome.
- To provide an overview of current therapeutic options for CKM syndrome.
Main Methods:
- Narrative review of existing literature.
- Synthesis of information on CKM syndrome pathophysiology.
- Overview of diagnostic and therapeutic strategies.
Main Results:
- CKM syndrome involves interconnected organ systems with shared pathophysiological pathways.
- Integrated management strategies are essential for holistic patient care.
- Current treatments include lifestyle modifications, glycemic/lipid control, and organ-specific protective therapies.
Conclusions:
- An integrated approach to CKM syndrome is crucial for effective management.
- Understanding CKM syndrome interactions can reduce public health burden and improve quality of life.
- Further research into CKM syndrome diagnostics and therapeutics is warranted.
Abstract:
Cardiovascular, renal, and metabolic diseases are pathophysiologically interdependent, posing a significant global health challenge and being associated with a substantial increase in morbidity and mortality. In 2023, the American Heart Association (AHA) defined this complex network of interconnected health conditions as the cardiovascular-kidney-metabolic (CKM) syndrome. This syndrome is based on common pathophysiological mechanisms, including chronic inflammation, oxidative stress, hyperglycemia and insulin resistance, activation of the renin-angiotensin-aldosterone system (RAAS), and neurohormonal dysfunction, which trigger a vicious cycle where the impairment of one organ contributes to the progressive deterioration of the others. An integrated approach to these conditions, rather than treating them as separate entities, supports a holistic management strategy that helps to reduce the burden on public health and improve patients' quality of life. Existing management focuses on lifestyle modification, glycemic and lipid control, and the use of nephroprotective and cardioprotective therapies. This narrative review aims to synthesize and contextualize existing information on the complex interactions between these systems and on diagnostic approaches, as well as to provide an overview of the available therapeutic options.
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