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cardiovascular-kidney-metabolic (CKM) syndrome

Cardiovascular, kidney, & metabolic diseases are pathophysiologically interrelated [1] 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 [2] - affects nearly 90% of Americans in 2024 [4] - major cause of death in 2021 [2] 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 [1] 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)

General

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

References

  1. Ndumele CE, Rangaswami J, Chow SL et al Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 2023. Oct 9. PMID: 37807924 Free article https://www.ahajournals.org/doi/10.1161/CIR.0000000000001184
  2. Aggarwal R, OstrominskivJW, Vaduganathan M. Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages in US Adults, 2011-2020. JAMA. Published online May 8, 2024 PMID: 38717747 PMCID: PMC11079779 (available on 2024-11-08) https://jamanetwork.com/journals/jama/article-abstract/2818457
  3. Lou N Time to Recognize Cardiovascular-Kidney-Metabolic Syndrome, AHA Says. Pooled cohort equations will make way for new CKM risk calculator
  4. Persaud N CKM Syndrome Affects the Vast Majority of Adults in the United States. Renal + Urology News. May 14, 2024 https://www.renalandurologynews.com/news/ckm-syndrome-affects-the-vast-majority-of-adults-in-the-united-states/ - Minhas AMK, Mathew RO, Sperling LS et al Prevalence of the Cardiovascular-Kidney-Metabolic Syndrome in the United States. J Am Coll Cardiol. 2024 May 7;83(18):1824-1826 PMID: 38583160 No abstract available. https://www.jacc.org/doi/abs/10.1016/j.jacc.2024.03.368