The therapeutic approach to cardiovascular-kidney-metabolic syndrome

Area of Science:

• Internal Medicine
• Nephrology
• Cardiology
• Endocrinology

Background:

• Obesity, type 2 diabetes mellitus, and chronic kidney disease (CKD) are prevalent and often coexist.
• These conditions significantly increase the burden of cardiovascular disease (CVD), mortality, and healthcare costs.
• The interplay between these conditions creates a complex clinical challenge, necessitating a unified approach.

Purpose of the Study:

• To introduce and define the concept of cardiovascular-kidney-metabolic (CKM) syndrome.
• To highlight the interconnected pathophysiological mechanisms linking obesity, diabetes mellitus, and CKD.
• To emphasize the importance of a holistic approach and population-level screening for CVD prevention.

Main Methods:

• The study proposes a conceptual framework for understanding CKM syndrome.
• It advocates for assessing absolute CVD risk using validated calculators.
• It stresses the need for screening adverse social determinants of health.

Main Results:

• CKD is identified as a critical risk factor, mediator, and therapeutic target for reducing CVD burden.
• Guideline-directed medical therapies for CKM syndrome can be tailored based on absolute CVD risk assessment.
• Integrating social determinants of health screening is crucial for comprehensive care.

Conclusions:

• CKM syndrome underscores the link between metabolic factors, CKD, and CVD, amplifying CVD risk.
• A multidisciplinary approach integrating lifestyle, risk factor control, and guideline-directed therapies is essential for managing CKM syndrome.
• Population-level screening and risk stratification are vital for effective CVD prevention across the lifespan.