Cardiovascular-Kidney-Metabolic Syndrome: Models of Care

Cardiovascular-kidney-metabolic (CKM) syndrome represents the complex interplay between cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders such as type 2 diabetes and obesity. These conditions share overlapping risk factors, pathophysiological mechanisms, and clinical outcomes, leading to progressive organ dysfunction, as well as increased morbidity and mortality. Traditional disease-specific care models, in which cardiology, nephrology, and endocrinology operate in separate clinics, are increasingly inadequate for addressing the integrated nature of CKM syndrome. Patients often experience fragmented care, with different specialties prioritizing different medications and communicating slowly via letters, which delays important guideline-directed medical therapy (GDMT) for each organ system, potentially leading to higher rates of hospital admissions and mortality. New models of care are urgently needed to improve outcomes through coordinated, patient-centered, and multidisciplinary approaches. Future integrated CKM care models should emphasize cross-specialty collaboration, data sharing, and shared decision-making to optimize treatment and deliver comprehensive care plans that consider all three specialty domains. Advances in digital health, precision medicine, and population health analytics can support these models by enabling more accurate risk stratification, personalized interventions, and continuous monitoring across the care continuum. This review, originating from an International Society of Nephrology Transplant Sister Center Meeting, synthesizes the available evidence on multispecialty clinics and other interventions designed to improve care for patients with multiple CKM comorbidities.