Cardio-renal-metabolic (CRM): Call for action for European Guidelines for Primary Care Physicians

Cardio-renal-metabolic syndrome (CRM) poses a critical and escalating threat to public health across Europe, demanding a unified and proactive approach. Current clinical practice is significantly limited by the absence of comprehensive, evidence-based CRM guidelines specifically designed for primary care physicians (PCPs). This deficiency leads to fragmented care and delays crucial early interventions. This article is a call to action for the immediate development of standardized European guidelines that enable the holistic management of CRM, prioritizing their swift adoption and implementation by PCPs across Europe. We urge a paradigm shift toward proactive screening, very early detection, and tailored, stage-specific management, recognizing PCPs as central coordinators of multidisciplinary care. To realize this, we propose concrete steps: robust PCP training in CRM diagnosis and management, the implementation of population-wide screening programs including eGFR, uACR, and NT-proBNP, and the removal of systemic barriers hindering access to optimal care. Moreover, we underscore the vital role of patient empowerment through education and support for self-management. This initiative aims to align national healthcare strategies with EU policy directives, fostering collaborative efforts among stakeholders to develop and implement contextually relevant guidelines. By establishing concise, actionable European guidelines, we can transform the management of hitherto separated medical disciplines spanning the CRM continuum, thereby improving patient outcomes and alleviating the substantial economic burden associated with this complex syndrome.