[CaReMe in primary care: Comprehensive strategies for managing patients with cardio-renal-metabolic conditions]

The cardio-renal-metabolic (CaReMe) syndrome captures the interplay among metabolic factors, kidney damage, and cardiovascular disease, constituting a progressive and preventable process. This educational practical review for primary care provides a practical stage-based (0-4) framework to facilitate patient detection, management, and follow-up. Opportunistic screening based on clinical history and simple measures (waist circumference, blood pressure, glucose, lipid profile), complemented by estimated glomerular filtration rate and albuminuria (chronic kidney disease classification) and by vascular risk estimation (SCORE2 or SCSORE2-OP by age), improves prognosis and reduces care burden. Management should be grounded in intensive lifestyle intervention as the cornerstone of care, with the addition of therapies with cardiorenal benefits in patients for whom they are indicated, based on an individualized assessment of risk and comorbidities. Implementing screening tools, adopting diagnostic and therapeutic algorithms, and ensuring effective coordination between primary and hospital care are essential to modify the natural course of this syndrome and to reduce cardiovascular events, slow kidney disease progression, and improve survival and quality of life.