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Published on: September 26, 2018
From Risk Determinants to Clinical Action: Understanding and Implementing the Cardiovascular‑Kidney‑Metabolic
Tazeen H Jafar1,2,3, Anqi Zhu1, Oluwabunmi Ogungbe4,5
1Program in Health Services Research and Population Health, Duke-NUS Medical School, Singapore.
Summary
Cardiovascular-kidney-metabolic (CKM) syndrome is a growing global health issue. This review synthesizes evidence on CKM syndrome, emphasizing integrated care and addressing social determinants of health for better outcomes.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
- Public Health
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome represents a significant and escalating global health challenge.
- It disproportionately affects socioeconomically disadvantaged populations, reflecting the intricate links between cardiovascular disease, chronic kidney disease, and metabolic dysfunction.
- Key drivers include excess adiposity, insulin resistance, inflammation, and vascular dysfunction.
Purpose of the Study:
- To review the development and progression of CKM syndrome.
- To highlight the roles of biological mechanisms, shared risk factors, and social determinants of health (SDOH) in its pathophysiology.
- To summarize the CKM health framework and discuss integrated care strategies.
Main Methods:
- A comprehensive synthesis of current scientific evidence on CKM syndrome.
- Analysis of the American Heart Association's CKM syndrome and health frameworks.
- Review of integrated cardio-kidney-metabolic care principles from major professional societies.
Main Results:
- CKM syndrome involves a progressive continuum of risk, from stage 0 to 4.
- Effective management requires a multidisciplinary approach combining lifestyle interventions and pharmacotherapies.
- Addressing biological mechanisms, shared risk factors, and SDOH is crucial for mitigating CKM syndrome.
Conclusions:
- Integrated CKM care, aligned with guidelines from AHA, ASN, KDIGO, and ADA, is essential.
- Practical strategies for integrating CKM care into routine practice are needed for feasibility and sustainability.
- Future efforts should focus on developing CKM clinical practice and public health guidelines to reduce morbidity and mortality.
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