Circulation· 2023Q1
A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association
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- Q1SCImago
- 2023year
Short summary
The American Heart Association defines Cardiovascular-Kidney-Metabolic (CKM) syndrome, highlighting its pathophysiology linking metabolic risk factors, chronic kidney disease, and cardiovascular disease, and outlining current evidence and critical knowledge gaps in its management.
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Key points
- CKM syndrome conceptualizes the interrelatedness of metabolic risk factors, chronic kidney disease, and cardiovascular disease.
- The confluence of these factors significantly increases the risk of adverse cardiovascular and kidney outcomes.
- Critical knowledge gaps exist in understanding disease mechanisms, clinical heterogeneity, and the impact of social determinants.
- Limitations in current data affect early prevention, screening, interdisciplinary care, lifestyle modification, and targeted therapies.
AI-generated from the title and abstract; the full text is not read.
Abstract
A growing appreciation of the pathophysiological interrelatedness of metabolic risk factors such as obesity and diabetes, chronic kidney disease, and cardiovascular disease has led to the conceptualization of cardiovascular-kidney-metabolic syndrome. The confluence of metabolic risk factors and chronic kidney disease within cardiovascular-kidney-metabolic syndrome is strongly linked to risk for adverse cardiovascular and kidney outcomes. In addition, there are unique management considerations for individuals with established cardiovascular disease and coexisting metabolic risk factors, chronic kidney disease, or both. An extensive body of literature supports our scientific understanding of, and approach to, prevention and management for individuals with cardiovascular-kidney-metabolic syndrome. However, there are critical gaps in knowledge related to cardiovascular-kidney-metabolic syndrome in terms of mechanisms of disease development, heterogeneity within clinical phenotypes, interplay between social determinants of health and biological risk factors, and accurate assessments of disease incidence in the context of competing risks. There are also key limitations in the data supporting the clinical care for cardiovascular-kidney-metabolic syndrome, particularly in terms of early-life prevention, screening for risk factors, interdisciplinary care models, optimal strategies for supporting lifestyle modification and weight loss, targeting of emerging cardioprotective and kidney-protective therapies, management of patients with both cardiovascular disease and chronic kidney disease, and the impact of systematically assessing and addressing social determinants of health. This scientific statement uses a crosswalk of major guidelines, in addition to a review of the scientific literature, to summarize the evidence and fundamental gaps related to the science, screening, prevention, and management of cardiovascular-kidney-metabolic syndrome.
The authors' abstract, as published at the source. Circulation, 2023 · DOI ↗
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Field: Nephrology
NephrologyMedicine