Cardio-renal-metabolic syndrome: statement by the Czech Society for Atherosclerosis Committee – year 2025

Czech version

Authors: Hana Rosolová ¹; Jan Piťha ²; Tomáš Freiberger ³; Pavel Kraml ⁴; Vladimír Blaha ⁵; Renata Cífková ⁶; David Karásek ⁷; Vladimír Soška ⁸; Tomáš Štulc ⁹; Michal Vrablík ⁹; Lukáš Zlatohlávek ⁹
Authors‘ workplace: Centrum preventivní kardiologie, II. interní klinika LF UK a FN Plzeň-Bory ¹; Klinika kardiologie IKEM, Praha ²; Genetická laboratoř CKTCH Brno ³; II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha ⁴; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ⁵; Centrum kardiovaskulární prevence 1. LF UK a FTN, Praha ⁶; III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP a FN Olomouc ⁷; Oddělení klinické biochemie, II. interní klinika LF MU a FN u sv. Anny v Brně ⁸; Centrum preventivní kardiologie, III. interní klinika – klinika endokrinologie a metabolizmu 1. LF UK a VFN v Praze ⁹
Published in: AtheroRev 2025; 10(3): 151-158
Category: Guidelines

Overview

Cardiovascular-kidney-metabolic syndrome (CKM) according to AHA and Systemic metabolic disorder according to EAS represents a new paradigm, which shows an interplay between cardiovascular and metabolic risk factors leading to arterial, heart, kidney and liver damage. Abdominal/visceral fatty tissue, insulin resistance, stimulated tissue renin-angiotensin-aldosterone system and sympathetic nervous system play the main role in the pathophysiology of that syndrome. Arterial hypertension, atherogenic dyslipidemia, prediabetes and type 2 diabetes, atherosclerosis and cardio-renal damage are developed during time. Visceral obesity induces systemic inflammation and oxidative stress which aggravate organs structure and function. Heterogenity of CRM syndrome is done by various epigenetic impacts, i.e. by interactions between genetic predispositions and environmental, life style and socio-economic factors. That syndrome contributes to high morbidity, invalidity and mortality in the population. The basic approach in the management and prevention of CRM syndrome lies in life style modifications. That measure could reverse or slow the development of organ complications. Diagnosis and drug treatment of the initial stages of CRM syndrome are in hands of general practicioners. In the latter stages the cooperation of specialists is unavoidable. There are mentioned pharmacotherapy of basic risk factors and diseases at the beginning of CRM syndrome.

Keywords:

obesity – metabolic syndrome – heart failure – type 2 diabetes – chronic kidney disease – cardio-renal syndrome

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