New condition highlights connection between heart disease, kidney disease, obesity and type 2 diabetes

Experts have long known that those who are living with heart disease are also more likely to be affected by kidney disease, type 2 diabetes and/or obesity. They have also been identifying intricate, entangled, and sometimes surprising connections that link each of these diseases together.

In late 2023, the American Heart Association  formally defined a new health condition that highlights the connection and shared risk factors between heart disease, kidney disease, type 2 diabetes and obesity. Cardiovascular-kidney-metabolic (CKM) syndrome happens when there is “a health disorder due to connections among heart disease, kidney disease, diabetes and obesity leading to poor health outcomes.” 

Master’s student Brandon Pattar, whose research focuses on kidney and cardiovascular health, says defining the new syndrome provides a more comprehensive framework for researchers and clinicians working at the intersection of all three conditions. 

Given that metabolic dysfunction (excess body fat or increased blood sugar) is defined as the first step in the CKM pathway, Pattar notes the new framework may also allow primary care providers to detect and prevent subsequent cardiovascular and kidney disease more easily. It’s an important benefit because these conditions impact millions of Canadians each year.

“The connections are complex, but this is a good way to recognize these conditions are all linked,” says Pattar. “It will allow for a more collaborative and holistic approach to research and care that will hopefully lead to better patient outcomes.”

Alongside clinician-researcher Dr. Sandra Dumanski, MD, Pattar is investigating markers of kidney disease that could help predict cardiovascular disease, and whether differences in the relationship between the kidneys and heart exist between males and females. This work will help improve understanding of key aspects in the CKM classification, and help contribute to the prevention, diagnosis, and treatment of these interrelated diseases. 

What you need to know about CKM

It’s important to know there are five stages of CKM, and each has a different treatment options. If you recognize yourself at any of these stages, talk to your health care provider and know that there are things you can do to prevent CKM from developing or worsening. 

At Stage 0, there are no CKM risk factors. Individuals are encouraged to prevent the syndrome by being active and eating healthy. 

At Stage 1 CKM there are early warning signs such as too much body fat and heightened blood sugar levels. Individuals are encouraged to adopt a healthy lifestyle, lose body fat and work with doctor to prevent progression to Stage 2. 

At Stage 2 CKM individuals may have high blood pressure or cholesterol, type 2 diabetes, or kidney disease. The recommendation is to adopt a healthier lifestyle, get your blood pressure, cholesterol and blood sugar checked annually and follow a doctor’s recommendations of treatments and medications to prevent things from getting worse.

Stage 3 CKM is where heart and blood vessel problems begin. At this stage, individuals may not be aware there are problems with their heart and blood vessel symptoms. Individuals should adopt a healthy lifestyle and get regular checkups. Doctors may alter your medications and dosages and you may need to undergo extra tests to look at your heart and arteries. 

At Stage 4 CKM, signs and symptoms of heart problems are noticeable. You may have had a heart attack, stroke or heart failure. You may or may not have kidney failure. At this stage, your health care team will come up with a personalized treatment for heart disease and other CKM syndrome conditions.