Understanding Cardiovascular-Kidney-Metabolic Syndrome (CKM): the Heart, Kidneys, and Metabolism Connection
If you've ever had high blood pressure, high blood sugar, or kidney issues, you might have thought of them as separate, unrelated health problems. But researchers have found that these conditions are often part of a bigger health issue. Called cardiovascular-kidney-metabolic syndrome (CKM syndrome), this recently recognized condition affects your major organs, including your heart, kidneys, liver, and brain.
We spoke with Sumeet Khetarpal, MD, a heart disease specialist at UVA Health, who explains that patients with CKM syndrome often have a mix of conditions. “Some patients have a constellation of different symptoms or problems that are developing in them, sort of simultaneously, that individually can be treated, but together form a risk problem,” Khetarpal says.
What Is CKM Syndrome?
The letters CKM stand for cardiovascular, kidney, and metabolic. It’s a complex condition made up of 4 related health issues:
- Problems with your heart and blood vessels (cardiovascular disease)
- Issues with your kidneys filtering waste (kidney disease)
- Problems with how your body uses sugar (type 2 diabetes)
- Having extra body fat (obesity)
People often have more than 1 of these conditions at the same time, because they’re all connected. “All of these organ systems really connect by our vasculature, the blood vessels,” says Khetarpal.
When you have CKM syndrome, problems in one area can lead to problems in another. For example, extra body fat can release substances that cause inflammation. This can damage the tissues in your heart and kidneys.
Silent Symptoms & Hidden Risks
One of the tricky things about CKM syndrome is that you might not feel sick in the early stages. You could have risk factors, like high cholesterol or high blood sugar, but without any discomfort.
“Patients can be surprised,” Khetarpal notes. “It's rare for patients to really feel any symptoms of this, just like patients might not necessarily feel the adverse effects of having increased abdominal fat tissue.”
However, as the condition progresses, symptoms can get worse or new symptoms may appear. These may include:
- Trouble breathing
- Swelling in your legs, feet, or hands
- Chest pain
- Tiredness (fatigue)
- Pain in your legs while walking
Because these risks add up, Khetarpal highlights that doctors need to look at the whole person. “The risk associated with having these features together is maybe more than the sum of their parts,” he says.
How Is CKM Syndrome Diagnosed?
We use several tests to check for CKM syndrome:
- Blood pressure
- Cholesterol and triglycerides (lipid panel)
- Blood sugar
- Kidney function
- Body Mass Index (BMI) and waist measurement
Based on these results, we can see which stage of the syndrome you might be in. The stages range from Stage 0 (no risk factors) to Stage 4 (diagnosed heart disease with symptoms).
Have Type 2 Diabetes? Struggling to Control It?
Keeping your diabetes under control is one way to prevent CKM syndrome from getting worse. See 4 ways to prevent a diabetic emergency.
Taking Control of Your Health
The good news is that you can change the stage you’re in by making healthy changes. Treatment usually starts with lifestyle changes like eating healthier foods, getting more exercise, and losing weight.
“Losing weight, lowering blood pressure, improving controlled blood sugar, lowering triglyceride and cholesterol levels, all together, will help protect the kidney function,” Dr. Khetarpal says.
If lifestyle changes aren't enough, your doctor might prescribe medicines to help manage blood pressure, cholesterol, or blood sugar.
Because CKM syndrome involves so many parts of the body, it often takes a team of healthcare providers working together to treat it best. This might include heart, kidney, and diabetes specialists, as well as others as you need.
Prevention Is Possible
You can lower your risk of CKM syndrome. Simple steps like getting enough sleep, avoiding tobacco, and staying active for 30 minutes a day can make a big difference.
It is also important to see your primary care doctor regularly. They’re often the first to spot the warning signs. “Primary care colleagues are at the helm of being able to help identify a lot of these risk factors,” notes Khetarpal.
By catching these issues early, you can work with your healthcare team to stop them from getting worse.