[The cardiorenometabolic syndrome as a new clinical paradigm in precision medicine]

Cardiorenal-metabolic syndrome (CRMS) is a pathophysiological interaction of metabolic, cardiovascular, and renal dysfunctions, sharing mechanisms such as chronic inflammation, insulin resistance, neurohormonal activation and vascular dysfunction. This progressive condition can begin in subclinical stages and evolve into established cardiovascular and renal disease. The CRMS staging classification stratifies patients from a stage with no risk factors (stage 0) to clinical cardiovascular disease with or without kidney failure (stages 4a and 4b). This framework guides interventions based on absolute risk and disease progression. The recently developed PREVENT model improves prediction of total cardiovascular risk (myocardial infarction, heart failure, stroke, and mortality) by incorporating variables from the cardio-renal-metabolic axis. Using this tool, therapeutic strategies can be personalized and patients who benefit most from intensive or combination therapies can be identified. Compared to traditional comorbidity-based approaches, CRMS demands an interdisciplinary, anticipatory, and patient-centered strategy. The implementation of integrated models improves clinical outcomes and promotes health equity. CRMS should be considered a strategic priority in precision medicine, public health, and global health policy.