CKM syndrome: A matter of the heart, kidneys and metabolism

Heart disease has long been linked to other chronic conditions, including diabetes and kidney disease. It is the leading cause of death for people in the U.S.; and 1 in 3 adults have three or more risk factors that contribute to heart disease, kidney disease or Type 2 diabetes, according to the American Heart Association (AHA).

Because of this, these interconnected health conditions are recognized by the AHA under one condition: cardiovascular-kidney-metabolic (CKM) syndrome. CKM is a health condition that affects your heart, kidneys and metabolism, which is your body's way of changing food into energy.

“There has been a distinct rise in the numbers of CKM patients not only at Sharp, but worldwide in industrialized countries,” says Dr. Robert Gillespie, a cardiologist affiliated with Sharp Memorial Hospital. “Early prevention is important to reduce your risk of CKM.”

What causes CKM?

CKM occurs when the heart, kidneys and metabolism are not working efficiently. Your heart supplies blood to every organ in your body, and your kidneys filter the blood your heart pumps. Damage to either of these organs leads to strain on the other.

According to Dr. Gillespie, heart disease, such as coronary artery disease and heart failure, is associated with an increased risk of other serious health conditions, including kidney disease and Type 2 diabetes. Additionally, the presence of diabetes affects the heart and kidneys.

Early findings indicate high blood pressure, high cholesterol and high blood sugar lay the foundation for CKM syndrome. These risk factors can lead to obesity and Type 2 diabetes, which in turn, can cause inflammation and stress in the body that can worsen kidney and heart function.

The goal in recognizing CKM syndrome is to get earlier diagnosis and treatment for people at high risk of dying from cardiovascular disease. “Early diagnosis and treatment, in addition to lifestyle changes, is critical in preventing the progression of CKM,” says Dr. Gillespie.

The 5 stages of CKM

There are five stages that identify patients’ risk for CKM along with specific treatments for each stage. While early stages call primarily for lifestyle changes that can be managed at home, medications and regular monitoring by your doctor may be necessary.

The 5 stages of CKM are:

• Stage 0: There are no risk factors for heart disease.

• Stage 1: Early warning signs, such as an unhealthy weight with excess abdominal fat or prediabetes, begin to show.

• Stage 2: Health risks start to show, including Type 2 diabetes, high blood pressure, high triglycerides or kidney disease.

• Stage 3: Heart and blood vessel problems begin alongside metabolic risk factors, such as high blood pressure, early cardiovascular disease or kidney disease, with symptoms not yet evident.

• Stage 4: Signs and symptoms of heart problems begin, such as diagnosed heart disease, excess body fat or kidney disease. Heart attacks, strokes or heart failure may have occurred.

Early stages of CKM syndrome can often be managed by your primary care doctor. If allowed to progress, the later stages of CKM syndrome will require one or more specialists, such as a cardiologist, nephrologist or endocrinologist. Identifying CKM syndrome early could lead to more collaborative care among your doctors.

“Prevention is a process that all physicians and other health care providers should emphasize, and they should educate patients who are at risk of developing CKM,” says Dr. Gillespie. “For patients already diagnosed, appropriate management is a team effort, since the presence of CKM may require various medication adjustments and interventions that can impact other organs.”

Reducing the risk of CKM

There are many steps you can take to reduce your risk for developing CKM syndrome, including practicing a healthy lifestyle. The American Heart Association recommends practicing “Life’s Essential 8,” key steps to boost your heart health, including:

• Eat a healthy diet consisting mostly of fruits, vegetables, whole grains, poultry and fish; and limit foods that are high in salt and sugar.

• Get at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity per week.

• Stop smoking or using other inhaled nicotine products, such as vapes.

• Get enough quality sleep — experts recommend adults get 7 to 9 hours of sleep each night.

• Reach and maintain a healthy weight through eating a healthy diet and getting regular exercise.

• Control your cholesterol by eating a healthy diet, exercising, refraining from tobacco products, and taking any medications as prescribed.

• Control your blood sugar level by knowing your glucose levels, sticking with a healthy diet, not smoking, regularly exercising, and taking any medications as prescribed.

• Manage your blood pressure by understanding blood pressure readings and tracking your levels, eating a healthy diet, being active, not smoking, managing your weight, sleeping well and taking any medications as prescribed.

Dr. Gillespie also recommends talking with your doctor about any health concerns and how you can improve your overall health. “Making lifestyle changes today is essential to reduce your risk for developing CKM,” he says.

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