심혈관-신장-대사증후군의 이해와 다학제적 접근의 필요성
Understanding Cardiovascular-Kidney-Metabolic Syndrome and the Necessity of a Multidisciplinary Approach
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Cardiovascular-kidney-metabolic (CKM) syndrome is a progressive disorder resulting from the complex interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), leading to multi-organ dysfunction. Given the increasing prevalence of metabolic syndrome, obesity, hypertension, dyslipidemia, and diabetes, a comprehensive approach to risk stratification and management is essential. The American Heart Association introduced the CKM staging system to classify disease progression and identify early intervention opportunities. Additionally, the predicting risk of cardiovascular disease EVENTs (PREVENT) equation was developed to enhance cardiovascular risk prediction by incorporating metabolic risk factors, estimated glomerular filtration rate, albuminuria, glycated hemoglobin (HbA1c), and social determinants of health. Unlike traditional risk models, PREVENT enables 10-year and 30-year risk prediction of both CVD and heart failure in individuals aged 30 to 79 years and integrates the social deprivation index for a more equitable and individualized risk assessment. However, as PREVENT is derived from United States population data, its applicability to Asian populations, including Koreans, remains uncertain. Developing a region-specific risk prediction model using local cohort data is crucial for optimizing CKM syndrome management. Furthermore, effective prevention and treatment require a multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, dietitians, and social workers. Implementing CKM staging and PREVENT in clinical practice can facilitate early risk identification and personalized interventions, ultimately improving cardiovascular and renal health outcomes.
Abstract
Cardiovascular-kidney-metabolic (CKM) syndrome is a progressive disorder resulting from the complex interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), leading to multi-organ dysfunction. Given the increasing prevalence of metabolic syndrome, obesity, hypertension, dyslipidemia, and diabetes, a comprehensive approach to risk stratification and management is essential. The American Heart Association introduced the CKM staging system to classify disease progression and identify early intervention opportunities. Additionally, the predicting risk of cardiovascular disease EVENTs (PREVENT) equation was developed to enhance cardiovascular risk prediction by incorporating metabolic risk factors, estimated glomerular filtration rate, albuminuria, glycated hemoglobin (HbA1c), and social determinants of health. Unlike traditional risk models, PREVENT enables 10-year and 30-year risk prediction of both CVD and heart failure in individuals aged 30 to 79 years and integrates the social deprivation index for a more equitable and individualized risk assessment. However, as PREVENT is derived from United States population data, its applicability to Asian populations, including Koreans, remains uncertain. Developing a region-specific risk prediction model using local cohort data is crucial for optimizing CKM syndrome management. Furthermore, effective prevention and treatment require a multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, dietitians, and social workers. Implementing CKM staging and PREVENT in clinical practice can facilitate early risk identification and personalized interventions, ultimately improving cardiovascular and renal health outcomes.