CKM: cardiovascular-kidney-metabolic syndrome
From AARP, June 13, 2024:
The American Heart Association says 1 in 3 U.S. adults have three or more risk factors for CKM syndrome, and it appears most adults are affected to some degree. In fact, a recent study published in the journal JAMA suggests nearly 90 percent of U.S. adults have some stage of CKM syndrome — a reflection of risk factors from being overweight to having chronic conditions like diabetes.…
Chiadi Ndumele, an associate professor of medicine and director of obesity and cardiometabolic research at Johns Hopkins University, says CKM syndrome is “a really potent driver” of premature deaths, including from heart disease. Cardiovascular deaths — once on the decline — are now increasing, evidence suggests. “This is thought to be all secondary to CKM syndrome,” says Ndumele, who coauthored the AHA advisory.
The causes and effects of CKM syndrome are wide-ranging. It’s not a simple flowchart but more of a spiraling storm — such as when obesity, a major cause of kidney disease, leads to a cascade of metabolic issues.
“When a kidney is damaged, by diabetes per se, or hypertension in particular, it produces a number of other abnormalities that affect the whole body — particularly the cardiovascular system,” says Katherine Tuttle, , professor of medicine in the division of nephrology at the University of Washington School of Medicine, and a coauthor of the AHA advisory. “It causes inflammation, it raises blood pressure, it makes people more resistant to insulin, it makes the lipid disorders worse.”
In turn, already high cholesterol levels can rise further; increasing insulin resistance inhibits the body’s ability to regulate blood sugar; and other changes take place — like kidney-disease-related calcium buildup in arteries\. Taken together, all these factors make circulation problems worse, which Tuttle says accelerates atherosclerosis, involving hardening and narrowing of the arteries, and heart failure….
For people who have some risk factors but don’t yet have heart or kidney disease, one of the biggest things is incorporating lifestyle changes, Aggarwal says, like exercising 150 minutes a week. That can help with losing weight and managing or preventing chronic conditions like diabetes.
For those who do have more advanced risks related to everything from diabetes to high cholesterol, experts recommend talking to your doctor about whether medications could help, in addition to lifestyle changes.
The American Heart Assocation has an online calculator to predict your risk of cardiovascular disease. Click here.
Note: You will need the numbers for your total cholesterol, HDL, SBP (systolic blood pressure), BMI, and eGFR (overall index of kidney function). To calculate your eGFR, go here.
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