You Don’t Want to Be a Part of This Threesome!
- Cardiovascular-kidney-metabolic (CKM) syndrome is a condition that happens when diabetes and kidney disease, heart issues, and metabolic troubles all become connected. When one problem gets worse, it puts more strain on the others.
- Risk factors include diabetes (primarily type 2 diabetes) hypertension, obesity, dyslipidemia, and chronic inflammation.
- Early diagnosis involves a combination of tests including blood pressure checks, cholesterol panels, and kidney function tests.
- Managing CKM syndrome and CKM treatment involves an integrated approach, addressing heart health, kidney protection, and metabolic control through lifestyle changes and medications like SGLT2 inhibitors and GLP-1 receptor agonists.
- Preventative measures like eating healthy, exercising regularly, maintaining a healthy weight, quitting smoking, and managing stress can help lower your risk and keep CKM syndrome from getting worse.
Reading Time: 4 minutes
Did you know that your heart and your kidneys are like a married couple? In sickness and in health, ‘til death do they part! This is especially true for people with diabetes.
People with diabetes – especially type 2 – often have multiple metabolic conditions like hyperglycemia (high blood sugar), hypertension (high blood pressure), obesity, and high cholesterol. These factors, in addition to conditions like inflammation, oxidative stress, and vascular dysfunction, form the basic abnormalities in heart and kidney disease. Together, these issues can lead to cardiovascular-kidney-metabolic (CKM) syndrome.
What Is Cardiovascular-Kidney-Metabolic Syndrome?
CKM syndrome is a condition where the heart, kidneys, and metabolic systems impact each other, creating a cycle where one condition makes the others worse.
For example, diabetes causes high blood sugar levels which can strain the heart and kidneys. Heart disease itself can also harm the kidneys, and poor kidney function can increase cardiovascular risks.
What Causes CKM Syndrome?
CKM syndrome is often triggered by underlying factors such as obesity, insulin resistance, hypertension, and chronic inflammation. Diabetes and kidney disease – along with these issues – can cause stress and damage to blood vessels and organs, leading to inflammation and poor function of the heart and kidneys.
What Are the Risk Factors for CKM Syndrome?
Type 2 diabetes plays a central role in the development of CKM syndrome. CKM syndrome can happen in people with type 1 diabetes, but it’s much more common in people with type 2.
Risk factors include:
- Type 2 diabetes
- High blood pressure (hypertension)
- Obesity
- Dyslipidemia (abnormal levels of cholesterol and triglycerides)
- Smoking
- Chronic inflammation
- Sedentary lifestyle
- Family history
- Age
What Are CKM Syndrome Symptoms?
CKM syndrome often develops gradually, and people don’t have symptoms in the early stages. However, when symptoms do occur, they can vary depending on which systems are most affected.
Heart-Related Symptoms
Kidney-Related Symptoms
- Shortness of breath, especially during physical activity or while lying down
- Fatigue and weakness
- Swelling in the legs, ankles, or feet (edema)
- Chest pain or discomfort
- Irregular heartbeat or palpitations
- Swelling in the hands, feet, or face due to fluid retention
- Changes in urination (e.g., foamy urine, decreased urine output, or frequent urination)
- High blood pressure that’s hard to control
- Nausea, vomiting, or loss of appetite (in advanced stages)
How is CKM Syndrome Diagnosed?
Getting an early diagnosis is crucial for the successful management of cardiovascular-kidney-metabolic syndrome.
Your doctor should run a combination of blood tests including a complete metabolic panel and urinalysis, an electrocardiogram and echocardiogram to assess heart function, and possibly imaging tests to evaluate kidney function.
Key tests for cardiovascular-kidney-metabolic syndrome include:
- Blood pressure test
- Lipid panel (total cholesterol, HDL, LDL, triglycerides)
- Metabolic panel that includes serum creatinine and GFR (glomerular filtration rate, which measures how well your kidneys are filtering your blood)
- Urine test for eGFR (estimated glomerular filtration rate) and UA/CR (urine creatinine ratio, which measures the amount of albumin and creatinine in your urine)
You may want to ask your doctor about getting a cardiac treadmill test (aka stress test), depending on your age and symptoms. You should also consider getting your own blood pressure cuff so you can measure your blood pressure at home at various times of day.
What Are the Treatments for Cardiovascular-Kidney-Metabolic Syndrome?
CKM treatment involves addressing the underlying conditions—heart disease, kidney disease, and metabolic issues—to prevent further damage and improve overall health. Treatment requires an integrated approach targeting all three areas:
Cardiovascular Support:
- Medications like beta-blockers, ACE inhibitors, ARBs, and mineralocorticoid receptor antagonists that help protect the kidneys and reduce heart strain
- Statins or other cholesterol-lowering drugs that reduce the risk of cardiovascular disease
- Device therapy (e.g., ICD or CRT in advanced heart failure)
Renal (Kidney) Protection:
- SGLT2 inhibitors
- Proper fluid management
- Adjusting medications to avoid damage to the kidneys
Metabolic Control:
- Blood sugar control using meds like GLP-1 RAs or SGLT2s that also provide protective benefits for the heart and kidneys
- Weight loss
Preventive Measures and Lifestyle Recommendations for CKM Treatment
The best way to address cardiovascular-kidney-metabolic syndrome is to start early in life with healthy habits. However, incorporating the following lifestyle modifications at any age can go a long way in supporting your overall health:
Nutrition:
A heart and kidney-friendly diet, such as the DASH or Mediterranean diet, focuses on whole grains, lean proteins, fruits, vegetables, and reduced salt and sugar.
Exercise:
Aerobic and strength-building exercises improve cardiovascular health, insulin sensitivity, and weight management.
Weight Management:
Losing excess weight can reduce strain on the heart, kidneys, and metabolic conditions.
Smoking Cessation:
Eliminating tobacco use helps improve blood vessel function and reduce disease progression.
Stress Management:
Practices like meditation and yoga can help control stress, which impacts blood pressure and glucose levels.
Key Takeaways
Cardiovascular-kidney-metabolic syndrome involves a complex interplay between diabetes and chronic kidney disease, cardiovascular disease, and metabolic issues. Managing the condition requires an integrated approach that addresses each condition.
If you’re experiencing symptoms like the ones mentioned above and you have risk factors such as diabetes, obesity, CKD, and cardiovascular disease, talk to your doctor.
A comprehensive treatment plan will ideally involve collaboration among healthcare providers—cardiologists, nephrologists, endocrinologists, and dietitians.
Early diagnosis, lifestyle modifications, and medications like SGLT2s and GLP-1s have shown promising results in lowering risks and improving outcomes. Learn more about the benefits of SGLT2s and GLP-1s and explore other type 2 diabetes management strategies in the TCOYD® video vault.
Additional Resources:
Keep Your Kidneys Kicking: Kidney Disease and Renal Health
A Dose of Dr. E: Protecting Your Kidneys
What Foods Should You Eat to Protect Your Kidneys
Show Some Love to Your Heart: Tips on Preventing Heart Disease
Reversing Type 2 Diabetes with a Plant-Based Diet
These 4 Minutes Can Save Your Life
Use sleep apnea machine
Sleep schedule is WAY off.
Living in a ⭕️ circular …?