Cardiovascular-Kidney-Metabolic (CKM) Syndrome

What is CKM syndrome?

CKM syndrome (cardiovascular-kidney-metabolic syndrome) is a newly named medical condition that affects most of your major organs, like your heart, kidneys, brain and liver. This complex disorder consists of four related medical issues and notes the links between them. These conditions are:

• Cardiovascular (heart and blood vessel) disease.
• Kidney disease.
• Type 2 diabetes.
• Obesity.

The letters CKM stand for cardiovascular, kidney and metabolic. Metabolic means getting energy from food. Obesity and Type 2 diabetes are metabolic conditions. Each of the four conditions in CKM syndrome can lead to or worsen one another.

People often have more than one of these conditions at a time. This isn’t surprising because these conditions share a connection through your blood. After you digest what you eat or drink, nutrients and energy travel through your blood to your body’s cells. Your heart and blood vessels circulate your blood through your body. And your kidneys filter wastes out of your blood. For good health, your body needs all of these systems to work well.

Having more than one of the listed conditions gives people with CKM syndrome risk factors for the others.

How common is CKM syndrome?

As a newly identified condition, CKM syndrome doesn’t have a history of data like conditions researchers found years ago. But 1 in 3 American adults has at least three of the risk factors for cardiovascular-kidney-metabolic syndrome.

What are the symptoms?

CKM syndrome symptoms may include any of the issues you get with the four conditions that make up cardiovascular-kidney-metabolic syndrome, like:

1. Chest pain.
2. Shortness of breath.
3. Syncope (passing out).
4. Swelling in your legs, feet, hands or ankles.
5. Pain in your legs while walking.
6. Tiredness.
7. Loss of appetite or an increase in appetite.
8. The need to pee more often.
9. Dry skin.
10. Sleep apnea.
11. Gout.

What causes CKM syndrome?

Extra adipose tissue (body fat) or body fat that’s abnormal causes CKM syndrome. This type of tissue releases substances that inflame and damage tissues in your heart, kidneys and arteries. Inflammation makes insulin less effective. It also encourages plaque and kidney damage to develop.

What are the risk factors for CKM syndrome?

Risk factors for CKM syndrome include:

• Obesity.
• Extra body fat around your waist.
• High cholesterol.
• High blood pressure.
• Kidney disease.
• Diabetes.
• Metabolic syndrome.

What are the complications of this condition?

Complications of CKM syndrome include:

1. Heart failure.
2. Arrhythmias (abnormal heart rhythms).
3. Heart attack.
4. Stroke.

How is CKM syndrome diagnosed?

Healthcare providers can use multiple tests to diagnose CKM syndrome.

These include:

• Checking your blood pressure.
• Ordering a lipid panel.
• Checking your blood sugar.
• Checking your kidney function.
• Measuring coronary artery calcium.
• Measuring BMI (body mass index).

Providers can screen children for these issues to give them an early start at preventing cardiovascular-kidney-metabolic syndrome.

A healthcare provider can use test results to diagnose you with CKM syndrome. Then they’ll choose from stages that progress from 0 to 4, with 4 being the highest-risk stage for cardiovascular disease.

CKM syndrome stages

The CKM syndrome stages are:

1. Stage 0: You have no risk factors.
2. Stage 1: You have extra body fat, especially in your belly.
3. Stage 2: You have Type 2 diabetes, high triglycerides, high blood pressure or kidney disease.
4. Stage 3: You have early cardiovascular disease (but no symptoms) or a high risk of it.
5. Stage 4: You have cardiovascular disease (with symptoms), extra body fat and risk factors for metabolic conditions. You may or may not have kidney failure.

You can change the stage you’re in by making changes to improve your health.

How is CKM syndrome treated?

Treatments for cardiovascular-kidney-metabolic syndrome vary by which of the related conditions you have. In treating CKM syndrome, healthcare providers can tailor a plan just for you. With multiple organs involved in CKM syndrome, your best bet is a treatment plan with input from several providers.

At an early stage, you may only need to make some lifestyle changes, like getting more physical activity.

If you’re at a middle stage, you may need to take medicines to manage blood pressure, cholesterol and blood sugar. People who have obesity may need medicine to decrease their appetite. Down the road, your provider may need to adjust how much of these medicines you take.

At more advanced stages, you may need:

• Stents to hold blocked arteries open for blood flow.
• Heart procedures like cardioversion or ablation.
• Open or minimally invasive heart surgery.
• Kidney dialysis.
• Weight loss (bariatric) surgery.

Complications/side effects of the treatments

Lifestyle changes don’t have any side effects, but many medications do. Talk to your provider if you have side effects that bother you. Surgeries and dialysis can put you at risk for infections and blood clots. Ask your provider about possible complications for the procedure you’re having.

How long does it take to recover from these treatments?

If you have a procedure or surgery, it can take a week or several weeks to recover. This depends on the kind of surgery you have, other conditions you have and other factors.

Can CKM syndrome be prevented?

Yes, some people can prevent CKM syndrome with a healthy lifestyle. For others, a healthy lifestyle may only slow the progression of CKM syndrome. Based on your family history, a healthcare provider can help you identify areas where you could have risks for cardiovascular-kidney-metabolic syndrome. They can work with you on a plan to be at your healthiest.

How can I lower my risk?

There are many ways you can lower your risk of CKM syndrome, like:

• Eating healthy foods.
• Getting enough sleep.
• Avoiding tobacco products.
• Managing blood pressure, blood sugar and cholesterol levels.
• Getting regular physical activity (30 minutes a day).
• Staying at a weight that’s healthy for you.

What can I expect if I have CKM syndrome?

With CKM syndrome, you can expect to have symptoms of the specific conditions involved. But having more than one condition can complicate your healthcare. Researchers are hoping for a future where everyone gets holistic treatment for CKM syndrome instead of treatment for one body system at a time. If you’re seeing multiple providers and you’re getting conflicting advice, speak up and ask for clear direction.

Outlook for CKM syndrome

Your outlook for CKM syndrome depends on how well you and your healthcare team can manage your conditions. You have the power to change your stage of cardiovascular-kidney-metabolic syndrome by getting the treatments your provider recommends.

How do I take care of myself?

You can take care of yourself by keeping healthy habits and following your provider’s advice. Ways to care for yourself may include:

1. Eating nutritious foods.
2. Getting physical activity.
3. Checking your blood sugar regularly if you have Type 2 diabetes.
4. Checking your blood pressure regularly with a home monitor.
5. Taking medications for the conditions you have.

When should I see my healthcare provider?

Keeping appointments with your providers is key to managing CKM syndrome. Seeing providers regularly allows them to monitor your risk factors or symptoms. It also helps them ensure that you’re managing your conditions well and taking the right amounts of medications. They can catch developing issues before they get worse and become harder to treat.

When should I go to the ER?

Call 911 or your local emergency services number if you have life-threatening complications from CKM syndrome. These may include:

1. Heart attack.
2. Stroke.
3. Hyperosmolar hyperglycemic state (HHS).

What questions should I ask my doctor?

Some questions to ask your provider may include:

• What’s the most important thing I can do to prevent CKM syndrome or change my stage?
• Should I be taking medicines to help me reduce my risk of CKM syndrome?
• How often do I need testing to check my progress in meeting my health goals?
• Should my family get testing for the conditions I have?

A note from Cleveland Clinic

CKM syndrome is a complex condition involving multiple organs. But researchers have found many ways to treat the various conditions that make up CKM syndrome. It’s in your best interest to use the treatments available to you so you can be at your best. Providers recognize that it’s difficult for some people to get nutritious food, pay for their prescriptions or be physically active. If you need help with any of these, ask your healthcare provider to refer you to programs that can help you live the healthy life you deserve.