In 2023, the American Heart Association (AHA) defined a triad of comorbidities—type 2 diabetes mellitus, cardiovascular disease (CVD), and chronic kidney disease (CKD)—as cardiovascular-kidney-metabolic (CKM) syndrome. The AHA identified 4 stages of CKM syndrome as well as a “prestage” of 0 that focuses on prevention and preservation of cardiac health (Table).

The AHA’s staging model emphasizes the progressive pathophysiology of the disease. It also underscores the importance of early assessment and prevention as cornerstones of patient care—with early detection and interventions often resulting in larger clinical benefit—and it highlights stepwise increases in CVD risk in patients with later stages of the disease.

Several classes of drugs have shown benefit in preventing cardiovascular events, decreasing cardiovascular mortality, and delaying CKD progression. In particular, antidiabetic agents such as sodium-glucose cotransporter 2 inhibitors have cardioprotective effects and can help prevent renal failure.

What protective strategies do you use for your patients at risk for CKM syndrome? How do you facilitate early treatment interventions to avoid disease progression and mitigate the risks of CVD events and kidney failure?