Cardiovascular-Kidney-Metabolic Syndrome in Women: Bridging Nephrology and the Female Cardiometabolic Disparity

The American Heart Association (AHA) introduced Cardiovascular-Kidney-Metabolic (CKM) syndrome to characterize a systemic disorder resulting from interconnected metabolic risks, CKD, and cardiovascular disease (CVD). The CKM Presidential Advisory outlines a five-stage framework (Stages 0-4) that categorizes individuals based on disease progression, risk, and opportunities for prevention or intervention. This framework is particularly significant for women, as sex-specific risk enhancers, including premature menopause and adverse pregnancy outcomes, influence CKM stage classification and long-term outcomes. The AHA PREVENT Scientific Statement presents PREVENT risk equations, which are sex-specific, race-neutral models designed to estimate absolute 10- and 30-year risk for total CVD, encompassing both atherosclerotic CVD and heart failure. These equations help clinical teams implement CVD prevention strategies and customize risk-reducing interventions. This review will focus on the impact of CKM syndrome in women, examine gaps in the current risk stratification and diagnostic strategy, and identify opportunities to improve prevention and management in this population.