Cardiovascular-kidney-metabolic syndrome: the interdisciplinary approach. A review

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Abstract

The revealed interrelationships between obesity, type 2 diabetes mellitus, cardiovascular diseases and chronic kidney disease are an important problem of modern healthcare worldwide, which is gradually becoming an epidemic. The study of these diseases in such a combination becomes the subject of discussion among scientists and the topic of various consensus documents. Factors such as hyperglycemia, insulin resistance, increased activity of the renin-angiotensin-aldosterone system, formation of glycation end products, oxidative stress, calcium metabolism disorders, mitochondrial malfunctions, and persistent chronic inflammation are fundamental to understanding of this syndrome (or disorder) and developing approaches to prevention and treatment. This review article describes both the basic principles of diagnosis and treatment of cardio renal metabolic syndrome and approaches to primary and secondary prevention.

About the authors

Olga Iu. Trushina

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: mironova_o_yu@staff.sechenov.ru
ORCID iD: 0000-0002-5820-1759

д-р мед. наук, проф. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

References

  1. Tsao CW, Aday AW, Almarzooq ZI, et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2023 Update: A Report from the American Heart Association. Circulation. 2023;147(8):e93-e621. doi: 10.1161/CIR.0000000000001123
  2. Salam AM, Carr AS. From “Heart and Reins” to Clinical Syndromes: Origin and Evolution of Cardio-Renal Disease. Heart Views. 2021;22:80-4. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_210_20
  3. Braunwald E. From cardiorenal to cardiovascular-kidney-metabolic syndromes. Eur Heart J. 2025;46(8):682-4. doi: 10.1093/eurheartj/ehae775
  4. Bright R. Cases and Observations, Illustrative of Renal Disease Accompanied with the Secretion of Albuminous Urine. Guy’s Hosp Rep. 1836;1:338-79.
  5. Lewis T. A clinical lecture on paroxysmal dyspnoea in cardio-renal patients: with special reference to “cardiac” and “uraemic” asthma: delivered at University College Hospital, London, November 12th, 1913. Br Med J. 1913;2(2761):1417-20. doi: 10.1136/bmj.2.2761.1417
  6. Heywood JT. The cardiorenal syndrome: lessons from the ADHERE database and treatment options. Heart Fail Rev. 2004;9(3):195-201. doi: 10.1007/s10741-005-6129-4
  7. Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-39. doi: 10.1016/j.jacc.2008.07.051
  8. Hatamizadeh P. Introducing nephrocardiology. Clin J Am Soc Nephrol. 2022;17:311-3. doi: 10.2215/CJN.10940821
  9. Braunwald E. Diabetes, heart failure, and renal dysfunction: The vicious circles. Prog Cardiovasc Dis. 2019;62(4):298-302. doi: 10.1016/j.pcad.2019.07.003
  10. Чазова И.Е., Шестакова М.В., Жернакова Ю.В., и др. Евразийские рекомендации по профилактике и лечению сердечно-сосудистых заболеваний у больных с диабетом и предиабетом (2021). Евразийский Кардиологический Журнал. 2021;(2):6-61 [Chazova IE, Shestakova MV, Zhernakova YuV, et al. Eurasian Association of Cardiology (EAC) Guidelines for the Prevention and Treatment of Cardiovascular Diseases in Patients with Diabetes and Prediabetes (2021). Eurasian Heart Journal. 2021;(2):6-61 (in Russian)]. doi: 10.38109/2225-1685-2021-2-6-61
  11. Миронова О.Ю., Староверов И.И., Сивакова О.А., и др. Контраст-индуцированное острое повреждение почек у больных хронической ишемической болезнью сердца в сочетании с сахарным диабетом и ожирением. Терапевтический архив. 2020;92(10):29-33 [Mironova OIu, Staroverov II, Sivakova OA, et al. Contrast-induced acute kidney injury in chronic coronary artery disease patients with diabetes mellitus and obesity. Terapevticheskii Arkhiv (Ter. Arkh.). 2020; 92(10):29-33 (in Russian)]. doi: 10.26442/00403660.2020.10.000753
  12. Ndumele CE, Neeland IJ, Tuttle KR, et al. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association. Circulation 2023;148(20):1636-64. doi: 10.1161/CIR.0000000000001186
  13. Миронова О.Ю., Сивакова О.А., Деев А.Д., Фомин В.В. Сердечная недостаточность и контрастиндуцированное острое повреждение почек у больных с ишемической болезнью сердца. Consilium Medicum. 2020;22(10):61-3 [Mironova OI, Sivakova OA, Deev AD, Fomin VV. Heart failure and contrast-induced acute kidney injury in patients with coronary artery disease. Consilium Medicum. 2020; 22(10):61-3 (in Russian)]. doi: 10.26442/20751753.2020.10.200352
  14. Миронова О.Ю., Фомин В.В. Прогностическая значимость контраст-индуцированного острого повреждения почек у больных с хронической ишемической болезнью сердца. Consilium Medicum. 2020;22(5):73-6 [Mironova OI, Fomin VV. Prognostic significance of contrast-induced acute kidney injury in chronic coronary artery disease patients. Consilium Medicum. 2020;22(5):73-6 (in Russian)]. doi: 10.26442/20751753.2020.5.200218
  15. Ndumele CE, Rangaswami J, Chow SL, et al. American Heart Association. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory from the American Heart Association. Circulation. 2023;148(20):1606-35. doi: 10.1161/CIR.0000000000001184
  16. Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022;386(21):2024-34. doi: 10.1056/NEJMra2115011
  17. Agarwal R, Filippatos G, Pitt B, et al. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43(6):474-84. doi: 10.1093/eurheartj/ehab777
  18. Vaduganathan M, Filippatos G, Claggett BL, et al. Finerenone in heart failure and chronic kidney disease with type 2 diabetes: FINE-HEART pooled analysis of cardiovascular, kidney and mortality outcomes. Nat Med. 2024;30(12):3758-64. doi: 10.1038/s41591-024-03264-4
  19. Agarwal R, Fouque D. The foundation and the four pillars of treatment for cardiorenal protection in people with chronic kidney disease and type 2 diabetes. Nephrol Dial Transplant. 2023;38(2):253-7. doi: 10.1093/ndt/gfac331
  20. Ferdinand KC, Rodriguez F, Nasser SA, et al. Cardiorenal metabolic syndrome and cardiometabolic risks in minority populations. Cardiorenal Med. 2014;4(1):1-11. doi: 10.1159/000357236
  21. Kim HL, Chung J, Kim KJ, et al. Lifestyle Modification in the Management of Metabolic Syndrome: Statement From Korean Society of CardioMetabolic Syndrome (KSCMS). Korean Circ J. 2022;52(2):93-109. doi: 10.4070/kcj.2021.0328
  22. Lloyd-Jones DM, Liu K, Colangelo LA. Consistently stable or decreased body mass index in young adulthood and longitudinal changes in metabolic syndrome components: the Coronary Artery Risk Development in Young Adults Study. Circulation. 2007;115(8):1004-11. DOI:10.1161/ CIRCULATIONAHA.106.648642
  23. Carnethon MR, Loria CM, Hill JO, et al. Coronary artery risk development in young adults study. Risk factors for the metabolic syndrome: the Coronary Artery Risk Development in Young Adults (CARDIA) study, 1985–2001. Diabetes Care. 2004;27(11):2707-15. doi: 10.2337/diacare.27.11.2707
  24. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. doi: 10.1161/CIR.0000000000000678
  25. Bolignano D, Palmer SC, Navaneethan SD, Strippoli GF. Aldosterone antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2014;(4):CD007004. doi: 10.1002/14651858.CD007004.pub3
  26. Alexandrou ME, Papagianni A, Tsapas A. Effects of mineralocorticoid receptor antagonists in proteinuric kidney disease: a systematic review and meta-analysis of randomized controlled trials. J Hypertens. 2019;37(12):2307-24. doi: 10.1097/HJH.0000000000002187
  27. Kolkhof P, Delbeck M, Kretschmer A, et al. Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury. J Cardiovasc Pharmacol. 2014;64(1):69-78. doi: 10.1097/FJC.0000000000000091
  28. Gerisch M, Heinig R, Engelen A, et al. Biotransformation of Finerenone, a Novel Nonsteroidal Mineralocorticoid Receptor Antagonist, in Dogs, Rats, and Humans, In Vivo and In Vitro. Drug Metab Dispos. 2018;46(11):1546-55. doi: 10.1124/dmd.118.083337
  29. Bakris GL, Agarwal R, Anker SD, et al. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med. 2020;383(23):2219-29. doi: 10.1056/NEJMoa2025845

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