Cardiovascular-Kidney-Metabolic (CKM) Syndrome

Cardiovascular-Kidney-Metabolic (CKM) syndrome is “a health disorder due to connections among heart disease, kidney disease, diabetes, and obesity leading to poor health outcomes.” An American Heart Association presidential advisory (released on October 9, 2023) defines CKM syndrome for the first time.

It is quite common for people to be diagnosed with overlapping cardiac, renal, and metabolic issues. More than one-fourth of adults have cardiovascular disease, chronic kidney disease or type 2 diabetes.

Age is a key factor in determining a person's risk of developing CKM syndrome. People who are age 65 or older are much more likely to be diagnosed with one or more of the three CKM syndrome conditions - heart disease, kidney disease, and diabetes.

Stages

As stated in the AHA 10/9/23 statement, CKM syndrome stages range from 0, or no risk factors and an entirely preventive focus, to Stage 4, the highest-risk stage with established cardiovascular disease. Stage 4 may also include kidney failure.

Each stage correlates to specific screenings and treatment therapies. A patient’s physician will order tests to determine the stage of the disease and to recommend the appropriate treatment. When a patient has more than one of the three CKM conditions, a collaborative care approach among multiple physician specialties is recommended.

Prevention and management

Approaches to prevention and management across the different stages of CKM syndrome were developed by the American Heart Association CKM Health Scientific Advisory Group. Interdisciplinary care and incorporation of social determinants of health (SDOH) were overarching considerations in developing this model of care.

Screening for CKM risk factors is suggested across the life courses to enhance approaches to prevention and management in both youth and adults.