CKM syndrome

Cardiovascular-kidney-metabolic (CKM) syndrome is an emerging clinical framework that integrates the interconnected burden of metabolic risk factors, chronic kidney disease, and cardiovascular disease. The syndrome is characterized by multidirectional pathophysiological interactions among dysfunctional adiposity, insulin resistance, inflammation, oxidative stress, endothelial dysfunction, renal injury, and cardiovascular remodeling, resulting in multiorgan dysfunction and increased cardiovascular morbidity and mortality. Recent guidance emphasizes staging of CKM syndrome from absence of risk factors to dysfunctional adiposity, established metabolic risk factors and/or chronic kidney disease, subclinical cardiovascular disease, and overt clinical cardiovascular disease. Epidemiological data indicate that CKM health impairment is highly prevalent, with a substantial proportion of adults falling within intermediate or advanced CKM stages. The CKM framework provides a practical approach for early risk identification, serial staging, and timely intervention before progression to heart failure, atherosclerotic cardiovascular disease, kidney failure, or other adverse outcomes. Management requires a holistic and multidisciplinary strategy, including lifestyle modification, obesity and adiposity management, routine assessment of estimated glomerular filtration rate and albuminuria, cardiovascular risk estimation, treatment of metabolic risk factors, and use of organ-protective therapies where appropriate. Early identification and integrated care at the right time and setting may reduce long-term cardiovascular, renal, and metabolic complications. CKM syndrome should therefore be recognized as an important clinical construct for endocrinologists, physicians, and multidisciplinary teams involved in cardiometabolic care. [J Assoc Clin Endocrinol Diabetol Bangladesh, 2026;5(Suppl 1): S10]