What Is CKM Syndrome?

Cardiovascular-kidney-metabolic (CKM) syndrome is defined by the American Health Association (AHA) as a health condition that acknowledges the overlap between cardiovascular (heart) disease, kidney disease, type 2 diabetes, and having obesity. With CKM syndrome, a person has several of these health problems that overlap, meaning that having one of these diseases or conditions can cause the others.

Here, we will explain CKM syndrome symptoms, the organs affected, risk factors, causes, and staging of the condition.

CKM Syndrome: Understanding Symptoms

To understand CKM syndrome, it is important to know what organs are affected by the condition and the associated symptoms.

Heart

CKM syndrome significantly affects the cardiovascular system, leading to a range of issues such as:

• Hardening of the arteries (atherosclerosis)
• A heart attack
• An irregular heartbeat (cardiac arrhythmias)
• Heart failure

Symptoms related to these conditions may include chest pain or discomfort, shortness of breath, irregular heartbeat, fatigue, and swelling in the legs, ankles, or feet due to fluid buildup.

Kidneys

CKM syndrome is strongly linked to chronic kidney disease (CKD) and its progression. Symptoms of kidney damage can include:

• Changes in urination frequency
• Weight loss
• Dry skin
• Swelling in the legs, ankles, or face due to fluid retention
• Fatigue
• Loss of appetite
• Difficulty sleeping

Liver

Metabolic dysfunction-associated steatotic liver disease (formerly known as nonalcoholic fatty liver disease) is also a consequence of CKM syndrome.

This is often referred to as a silent disease in that it doesn't typically cause symptoms. But if symptoms are experienced, they may include:

• Fatigue
• Abdominal discomfort

In advanced stages, it can lead to liver failure.

Pancreas

CKM syndrome may affect the pancreas and is highly associated with type 2 diabetes. Diabetes leads to symptoms like:

• Increased thirst
• Frequent urination
• Weight loss
• Fatigue
• Blurry vision

What Leads to CKM Syndrome?

The prevalence of obesity and type 2 diabetes in both adults and youth has historically paved the way for the emergence of CKM syndrome.

Risk Factors

In the United States, about one-third of adults have with three or more risk factors linked to the onset of CKM syndrome. These risk factors are:

• Elevated blood pressure (hypertension)
• High blood sugar levels (diabetes)
• Abdominal fat
• High cholesterol or triglyceride levels
• Underlying kidney conditions

Each of these risk factors increases your chances of having cardiovascular disease, stroke, and type 2 diabetes.

Causes

CKM syndrome happens when problems like obesity and diabetes, kidney disease, and heart issues all interact. This damage sets off a chain reaction, making things like insulin resistance and inflammation worse. The cycle created harms these organs more over time.

Diagnosis: How Do I Know I Have CKM Syndrome?

Screening for CKM syndrome aims to detect early cardiovascular, metabolic, and kidney health changes. In addition, it also identifies barriers to care in order to prevent progression to subsequent stages.

Stages of CKM are on a continuum from stage 0 (no risk factors) to stage 4 (symptomatic cardiovascular disease). With each stage are recommendations that emphasize: preventive measures, lifestyle modifications, and treatments specific to each stage.

Annual screenings play a pivotal role in monitoring advancements and directing comprehensive care. These screenings encompass:

• Waist circumference
• Body mass index
• Blood pressure
• Cholesterol level measurements
• Blood sugar measurements

Stages of CKM Syndrome

The stages of CKM syndrome are as follows:

• Stage 0, meaning no CKM risk factors: The emphasis in this stage includes promoting healthy habits and aiming to maintain optimal health.
• Stage 1, meaning excess body fat and an unhealthy distribution of body fat: This stage also includes impaired glucose intolerances or prediabetes. Treatments aim for at least 5% weight loss and addressing excess body fat or unhealthy distribution while supporting healthy lifestyle changes.
• Stage 2, meaning metabolic risk factors and kidney disease: Stage 2 includes people with type 2 diabetes, high blood pressure, high triglycerides, and kidney disease. People in this stage have a higher risk for worsening kidney disease and heart disease. This stage typically requires medications to manage blood pressure, blood sugar, and cholesterol.
• Stage 3, meaning early cardiovascular disease without symptoms, kidney disease, or those at high predicted risk for cardiovascular disease: In stage 3, the focus is on preventing high-risk individuals from progressing to cardiovascular disease and kidney failure by adjusting medications and emphasizing lifestyle changes.
  
• Stage 4, meaning symptomatic cardiovascular disease in people with excess body fat, metabolic risk factors, or kidney disease. Stage 4 has two parts: 4a for those without kidney failure, and 4b for those with it. At this stage, individuals might have experienced heart issues like heart attacks, stroke, heart failure, or related conditions. The focus is on personalized cardiovascular care.
  

Treating CKM Syndrome

Lifestyle changes and weight loss might help reverse or improve the stages linked to CKM syndrome. By embracing healthier habits like changing diet, exercising more, and managing weight, individuals can treat (or even reverse) their CKM syndrome stages.

This regression has the most potential in stages 1, 2, and 3 of CKM syndrome. At these stages, lifestyle adjustments tend to have a more substantial impact. As individuals make these changes, they may experience positive outcomes, such as:

• Better glucose control
• Improved cholesterol
• Improved blood pressure levels
• Weight reduction
• Improved kidney function
• Improvements in certain types of heart dysfunction
  

Essentially, CKM syndrome regression embodies the idea that proactive lifestyle alterations can potentially halt or reverse the progression of CKM syndrome, leading to an overall better state of health.

CKM Syndrome Prevention: Steps to Take Now

CKM syndrome prevention is possible by adopting the AHA's Essential 8 healthy habits. These eight health behaviors are crucial for enhancing and sustaining cardiovascular well-being to reduce the likelihood of heart disease, stroke, and various other significant health concerns:

Eat Better

Read nutrition labels to help make better choices. A heart-healthy diet involves consuming plenty of the following:

• Fruits
• Vegetables
• Whole grains
• Beans
• Legumes
• Plant-based proteins
• Skinless poultry
• Lean animal proteins, and
• Fish and seafood

Limit saturated fats, sweet drinks, alcohol, red meats, highly processed foods, foods with added sugars, and tropical oils like palm and coconut oil. Avoid trans fats and partially hydrogenated oils. 

Get Active

Engaging in regular physical activity promotes heart health. Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous aerobic activity per week. Kids and teens should aim for 60 minutes of physical activity every day.

Stop Smoking

Quitting smoking is crucial for heart health. Smoking damages the heart and blood vessels, significantly increasing the risk of heart disease. Smoking is also the most preventable cause of death in the United States.

Get Healthy Sleep

Most adults need seven to nine hours of sleep each night. Poor sleep may increase the risk of:

• Cardiovascular disease
• Obesity
• Depression
• Cognitive decline and dementia
• High blood pressure, blood sugar and cholesterol
  

Maintain a Healthy Weight

Keeping a healthy weight reduces the risk of heart disease and other health issues. Understanding your body mass index (BMI) can help you know if you are at a healthy weight. Your healthcare provider can help you calculate this number.

Control Cholesterol

Maintaining healthy levels of cholesterol, specifically low-density lipoprotein (LDL) cholesterol (considered bad cholesterol), is important to prevent plaque buildup within the walls of arteries.

Manage Blood Sugar

Monitoring and controlling blood sugar levels help prevent diabetes and reduce the risk of heart disease. Tips include eating a healthy diet and limiting sugary foods, red meats, processed foods, and refined carbohydrates.

Manage Blood Pressure

Keeping blood pressure within a healthy range, which is considered below 120/80 millimeters of mercury (mm Hg), is crucial to reduce strain on the heart and blood vessels.

Life With CKM Syndrome

CKM syndrome is a progressive condition, meaning it gets worse over time, especially without interventions or changes in lifestyle habits. In addition, it can start as early as childhood (although the new AHA advisory is only geared for adults).

The AHA emphasizes the importance of prevention. However, even those with CKM syndrome can make improvements to their health and overall well-being through healthy lifestyle behaviors at every age and stage of CKM. It is possible to reverse to a lower stage, thereby improving one's quality of life.

Summary

CKM syndrome, which includes cardiovascular, kidney, and metabolic health, presents a complex web of conditions with profound implications for overall health. This syndrome involves the connectedness between heart disease, diabetes, obesity, and kidney dysfunction.

Prevention and even potential regression through lifestyle modifications are possible. Proactive management can help improve health outcomes at every stage. Talk to your healthcare provider for a tailored approach to managing CKM syndrome that is right for you.