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Cardiovascular-Kidney-Metabolic (CKM) Syndrome

You may think of diabetes, chest pain, swelling, and shortness of breath as being unrelated. But those symptoms may be signs of an underlying condition. Cardiovascular-kidney-metabolic syndrome (CKM syndrome) is a condition caused by how closely your heart, kidneys, and metabolism are linked. These conditions, which were once thought of as separate problems, often happen together and make each other worse.

CKM syndrome can affect most of your major organs, including your heart, kidneys, brain, and liver. By treating these connected health issues as one syndrome, your healthcare team can create a better plan to protect your health.

Treating CKM Syndrome at UVA Health

Treating CKM syndrome means treating all the related conditions at the same time. Because multiple organ systems are involved, it’s best to create a care plan with input from several specialists. Here, those specialists are already working together under one roof.

Early-Stage Treatment

At the earliest stages, treatment focuses on lifestyle changes to manage your risk factors and prevent the syndrome from getting worse. These changes can have long-term benefits for your CKM health:

  • 
Eat healthy foods
  • 
Get regular physical activity (30 minutes a day)
  • 
Stay at a healthy weight
  • 
Get enough sleep
  • 
Avoid tobacco products

Medication & Advanced Treatment

If lifestyle changes aren’t enough, we may recommend medicines to manage your conditions. In advanced stages, you may need a team of specialists, including those that treat your heart (cardiologists), kidneys (nephrologists), and diabetes (endocrinologists).

Treatment options include:

  • Medications to manage high blood pressure, cholesterol, or blood sugar, including newer medicines that treat both diabetes and obesity.

  • Bariatric surgery
  • Kidney dialysis, if you have kidney failure
  • Heart procedures, like stents to open blocked arteries or heart surgery
  • Referral to a nutritionist or dietitian to help you create a healthy eating plan

Keeping appointments with your providers is key to managing CKM syndrome. Seeing your doctor regularly allows us to watch your risk factors and make sure you're getting the right care. We can catch issues before they get worse and become harder to treat.

What Is CKM Syndrome?

The letters CKM stand for cardiovascular, kidney, and metabolic. This complex health issue includes 4 related health issues:

  • Cardiovascular disease: Problems with your heart and blood vessels.


  • Kidney disease: When your kidneys don't properly filter waste from your blood.



  • Type 2 diabetes: A condition affecting how your body uses blood sugar for energy.



  • Obesity: Having excess body fat or weight.






When you have CKM syndrome, problems in 1 area can quickly lead to problems in another. The main cause is often extra body fat (adipose tissue), especially around your waist. This fat tissue releases substances that cause inflammation, which damages tissues in your heart, kidneys, and arteries. This damage can cause plaque to build up in your arteries and make your body's insulin less effective at controlling your blood sugar.

CKM Syndrome Symptoms

In the early stages, you may have risk factors that you can’t feel, like high blood pressure or high triglycerides. But as CKM syndrome progresses, you may start to feel symptoms that are affecting your heart and other organs, like:

  • Shortness of breath
  • Chest pain or chest pressure
  • Tiredness (fatigue)
  • Swelling in your legs, feet, hands, or ankles
  • Pain in your legs while walking
  • The need to pee more often
  • Dizziness or fainting (syncope)

Diagnosing CKM Syndrome: Staging Your Risk

CKM syndrome is diagnosed by using multiple tests to check for a combination of risk factors. Your healthcare provider may check:

  • Your blood pressure 



  • Your blood sugar
  • Your cholesterol and triglycerides (a lipid panel) 



  • Your kidney function 


  • Your body mass index (BMI) and waist measurement 




Based on these results, we'll assign a stage to help you understand your health and decide on the best plan of action to treat and manage your symptoms.

  • Stage 1: You have excess body fat, especially around your waist or belly
  • Stage 2: You have high blood pressure, Type 2 diabetes, high triglycerides, kidney disease, or metabolic syndrome
  • Stage 3: You have early signs of cardiovascular disease but do not yet have symptoms, or you are at very high risk of developing it
  • Stage 4: You have been diagnosed with cardiovascular disease and are showing symptoms, and you may or may not have kidney failure

The good news is that you may be able to change the stage you're in by working with your healthcare team on strategies to manage your symptoms.

Taking the Next Step

If you have risk factors or ongoing symptoms that concern you, talk to your doctor about CKM syndrome. Finding a team that understands how your heart, kidneys, and metabolism work together can help you manage your symptoms and improve your quality of life.