Cardio-kidney-metabolic (CKM) framework: A nephrologist's perspective.

Area of Science:

• Nephrology
• Cardiology
• Metabolic Diseases
• Public Health

Background:

• The cardio-kidney-metabolic (CKM) framework integrates cardiovascular, renal, and metabolic health.
• Chronic kidney disease (CKD) is often overlooked in current cardiovascular risk assessments.
• Limited application of the CKM framework in kidney care necessitates further evidence and strategic development.

Purpose of the Study:

• To provide a nephrology-focused perspective on the CKM framework.
• To emphasize the bidirectional links between CKD and cardiovascular/metabolic diseases.
• To highlight challenges in CKD detection and management within the CKM pathway.

Main Methods:

• Review of current literature and real-world data on CKM and CKD.
• Analysis of implementation gaps and outcomes in CKD management.
• Examination of challenges faced by nephrologists, particularly in low- and middle-income countries.

Main Results:

• CKD is underrecognized and receives delayed attention in the CKM pathway.
• Significant implementation gaps, suboptimal outcomes, and economic burdens are associated with delayed CKD management.
• Workforce shortages, late referrals, and fragmented care hinder nephrology practice.

Conclusions:

• The CKM framework requires a data-driven, evidence-based approach for successful implementation.
• Improved multidisciplinary coordination is essential for integrating CKD into the CKM strategy.
• Addressing challenges in early CKD detection and management is critical for optimizing CKM care.