The Cardiovascular-Kidney-Metabolic Health Framework: Implications for Nephrology

Metabolic risk factors, CKD, and cardiovascular disease are highly prevalent, frequently coexist, and adversely affect lifespan and health span globally. The American Heart Association (AHA) recently defined Cardiovascular-Kidney-Metabolic (CKM) syndrome to highlight the interconnectedness between these conditions, across biological and socioecological domains. The CKM health initiative of the AHA seeks to improve cardiovascular and kidney health at a population level by providing a holistic approach to the management of individuals with CKM syndrome, emphasizing CKM health across the lifespan with priority for primordial/primary prevention, improving short and long-term cardiovascular risk prediction, and presenting an implementation framework for multidisciplinary health care models across diverse health care settings. CKD is a key risk factor, mediator, and therapeutic target to reduce cardiovascular disease burden and is represented across all aspects of the AHA CKM health framework. This review article highlights the major take-aways for nephrologists from the AHA CKM health initiative. It outlines the areas where nephrologists can affect the delivery of holistic CKM care as part of the multidisciplinary team. Finally, it describes a potential future role for nephrology to guide and implement screening and early interventions for kidney disease, to move the needle toward kidney health at a population level.