Trends in nephrology: cardiovascular kidney-metabolic syndrome

Cardiovascular disease (CVD), chronic kidney disease (CKD), diabetes, and obesity frequently coexist and share overlapping pathophysiological mechanisms, contributing to poor health outcomes and high mortality. Recognising this interaction, the cardiovascular-kidney-metabolic (CKM) syndrome has been proposed to advance and unify the concepts of cardiorenal syndrome and metabolic syndrome. CKM syndrome is staged from 0 to 4, reflecting disease progression tracking and risk stratification, and emphasizes life-course screening to detect early metabolic and kidney abnormalities. Early identification of albuminuria and reduced kidney function, even in youth with metabolic risk factors, may slow CKD progression and reduce long-term complications. Further development and validation of risk prediction tools for major cardiovascular and kidney failure events in patients with CKM will help to guide individual therapeutic intervention. For nephrologists, this paradigm offers an opportunity to be involved in the interdisciplinary care model. In the future CKM care model, it would be ideal to have dedicated CKM coordinators in place to enhance collaboration between primary care and all the other specialties involved to improve outcomes, and reduce the global burden of CKM syndrome.