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Renal Replacement Therapy in Cardiovascular-Kidney-Metabolic Syndrome: Challenges for Dialytic Therapies and Kidney

Mahtab Mashayekhi1, Jasjot Bhullar1, Zohreh Gholizadeh Ghozloujeh1

  • 1Division of Nephrology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, California, USA.

Cardiorenal Medicine
|June 4, 2026
PubMed

Insights

Cardiovascular-kidney-metabolic (CKM) syndrome links heart disease, kidney disease, and metabolic issues. This review explores challenges and treatments for advanced CKM patients undergoing dialysis or kidney transplant.

Area of Science:

  • Nephrology
  • Cardiology
  • Metabolic Disorders

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome highlights the intricate links between cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic conditions like obesity and diabetes.
  • Renal replacement therapy (RRT) is crucial for managing advanced CKD.
  • Kidney failure presents distinct challenges, especially when combined with heart failure, ischemic heart disease, and metabolic syndrome.

Purpose of the Study:

  • To review the challenges and therapeutic considerations for dialytic therapies in patients with CKM syndrome.
  • To evaluate kidney transplantation as a therapeutic option for patients with CKM syndrome.

Main Methods:

  • Literature review focusing on CKM syndrome, RRT, and kidney transplantation.
  • Analysis of current therapeutic strategies and outcomes.

Main Results:

  • CKM syndrome complicates management due to interconnected pathophysiology.
  • Dialytic therapies require careful consideration of cardiovascular and metabolic status.
  • Kidney transplantation offers potential benefits but necessitates comprehensive pre-transplant evaluation and post-transplant management.

Conclusions:

  • Integrated management strategies are essential for CKM syndrome.
  • Optimizing RRT and transplantation requires a multidisciplinary approach.
  • Further research is needed to refine treatment protocols for CKM patients.
Abstract

Keywords:
Cardiovascular diseaseCardiovascular-kidney-metabolic syndromeRenal replacement therapyTransplantation

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