The Kidney in the Middle: KDIGO Guidelines Address Multiple Key Components of Cardiovascular-Kidney-Metabolic Syndrome.

Abstract

Chronic kidney disease (CKD) is closely intertwined with obesity, diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD). In 2023, the American Heart Association formally recognized these interconnections as a unified entity, the cardiovascular-kidney-metabolic (CKM) syndrome. The CKM syndrome brings renewed attention to the importance of CKD in CVD and reinforces the need for effective, evidence-based, interdisciplinary approaches to diagnose and prevent its intersecting components. The Kidney Disease: Improving Global Outcomes (KDIGO) organization has long led efforts to synthesize knowledge and translate evidence to practice in this area through the lens of the kidney. This review highlights KDIGO Clinical Practice Guidelines and Controversies Conference publications that directly address the CKM syndrome. These include guidelines addressing CKD, blood pressure, diabetes, and lipids; an upcoming guideline addressing heart failure in CKD; and Controversies Conference reports addressing obesity and CKD prevention. Overarching themes include the importance of early detection and intervention; comprehensive, personalized management of kidney and cardiovascular risk; and multidisciplinary care. Through integrated, evidence-based, disease-specific guidelines and reports, KDIGO has established a robust framework for the management of people at risk for or with CKM syndrome as well as priorities for ongoing research.