Comprehensive assessment of Cardiovascular-Kidney-Metabolic (CKM) syndrome: Novel tools for assessment of cardiovascular risk and kidney outcomes in long-term kidney transplant patients

WHAT'S NEW?The newly defined cardiovascular-kidney-metabolic (CKM) syndrome offers a framework for evaluating cardiovascular (CV) risk, which is particularly useful in stable kidney transplant (KTx) patients, as CV causes are a leading cause of death and graft loss.This study aimed to explore the relationship between CKM stage, clinical characteristics, and potential markers, like the histone deacetylase sirtuin-1 and adipokine chemerin.We demonstrate that classification into CKM stage allows for both CV and renal risk stratification.Only highlysensitive interleukin-6 differed significantly by CKM class, which implies incremental, lowgrade inflammatory burden.High sirtuin-1 concentrations were prognostic regarding favorable CV and renal outcome.In contrast, circulating chemerin levels were associated with renal disease severity.These findings likely parallel intertwined pathophysiological pathways in CKM, which may be indirectly tracked by these candidate marker assessments.This study aligns with the growing emphasis on multiorgan assessment in CV health, reflecting evolving paradigms in clinical practice.