cardiovascular-kidney-metabolic (CKM) syndrome

Introduction

Cardiovascular, kidney, & metabolic diseases are pathophysiologically interrelated

Classification

• risk stratefication
  • Stage 0: no risk factors
  • Stage 1: excess body fat &/or impaired glucose tolerance or prediabetes
  • Stage 2: metabolic risk factors present
  • Stage 3: early, asymptomatic cardiovascular disease
  • Stage 4: cardiovascular disease with or without chronic renal failure

Epidemiology

• high prevalence in the population
  • disproportionately affecting socially disadvantaged individuals
• cardiovascular, kidney, & metabolic diseases have affected 25% of US adults between 2015-2020
  • affects nearly 90% of Americans in 2024
• major cause of death in 2021

Monitor

• assess blood pressure, weight <= every 3-5 years

Laboratory

• screening* to assess
  • lipid panel
  • blood glucose or hemoglobin A1c

* every 3-5 years stage 0, every 2-3 years stage 1, every year stage 2

Radiology

• consider coronary artery calcium screening (stage 3)

Complications

• high incidence of cardiovascular disease events & cardiovascular mortality

Management

• prevention based on the AHA Life's Essential 8
  • + at least 5% weight loss (stage 1)
  • treat type 2 diabetes, hypertension, dyslipidemia, kidney disease (stage 2)
  • intensify prevention treatment (stage 3)
  • individualized treatment for cardiovascular disease with consideration for
    • CKM syndrome conditions (stage 4)

More general terms

• cardiovascular disease (CVD)
• chronic renal failure (CRF)
• metabolic syndrome X; obesity syndrome x; insulin-resistance syndrome; dysmetabolic syndrome