Cardiovascular-Kidney-Metabolic Syndrome – What can be Done in Childhood?

Abstract Purpose of Review Cardiovascular-kidney-metabolic (CKM) syndrome is a recently introduced term by the American Heart Association to describe the interconnected nature of obesity, chronic kidney disease, type 2 diabetes, and cardiovascular disease. These conditions are major contributors to adult morbidity and mortality; however, not limited to adults. There is a notable gap in the literature regarding CKM in pediatric population. In this context, we explore CKM syndrome in children, its pathophysiology, definition, age-specific risk factors, diagnostic options, and suggest early intervention strategies that could significantly influence CKM outcomes. Recent Findings CKM syndrome originates from chronic inflammation and oxidative stress triggered by excessive and dysfunctional adipose tissue, resulting in damage to the arteries, heart, and kidneys, and contributing to insulin resistance. Components of CKM syndrome are key factors in the development and progression of cardiovascular disease, with evidence of deleterious effects on vascular injury and atherosclerosis from very early life, even prenatal exposure. Several cardiovascular risk factors have been linked to early vascular changes, leading to the onset of CKM syndrome during childhood or increasing the risk of its earlier manifestation in adulthood. Children may remain asymptomatic for a long time, making screening and early identification critical. Obesity is often the entry point into the CKM pathway. In addition, genetic and familial conditions (e.g., familial hypercholesterolemia, monogenic diabetes, congenital nephropathies) should be considered early. Summary The pathophysiological effects of obesity in children lead to the development of cardiovascular-kidney-metabolic syndrome in adulthood. Childhood is an entry point for early identification and intervention.