Definition, Classification, Diagnosis, and Management of an Emerging Threat: Cardio-Renal-Metabolic Syndrome

Cardio-renal-metabolic (CRM) syndrome is an emerging nosological entity that reflects the interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disorders. In recent years, it has attracted particular interest, as it appears to be associated with a growing incidence of cardiovascular events, progression of kidney disease, and mortality. The fact that the syndrome has a complex pathophysiology, multiple risk factors, and deleterious effects on different organs and systems necessitates an interdisciplinary approach to its management. Pharmacological agents with positive effects on different components of CRM syndrome, such as sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists, have recently been added to our pharmacological arsenal. However, these treatments are underprescribed and used at disproportionately low rates given the significant benefits they offer and the strong level of evidence supporting them, highlighting the need for greater vigilance among physicians regarding the recognition and treatment of the syndrome. This article provides recent data on the definition, pathophysiology, staging, and diagnosis of CRM syndrome and the holistic management of affected patients.