Cardiovascular-kidney-metabolic syndrome, the prevalence of risk factors and stages in Kyiv region: a cross-sectional study

American Heart Association (AHA) introduced the cardiovascular-kidney-metabolic (CKM) syndrome to emphasise the interconnected roles of heart, blood vessels, kidneys and metabolism and classified it into 5 stages.The objective: to determine the prevalence of risk factors and stages of CKM syndrome among working-age patients at the primary care level.Materials and methods. 163 working-age patients participated in the study, who were randomly selected at the primary care level in the Kyiv region. The anthropometric and laboratory indicators (glucose, HbA1c, insulin, lipidogram, serum creatinine, HOMA-IR index and urinary albumin-creatinine ratio) were assessed. The estimated glomerular filtration rate, 10-year and Lifetime Atherosclerotic Cardiovascular Disease (ASCVD) risk score were calculated. The KDIGO (Kidney Disease: Improving Global Outcomes) and CKM syndrome stages were established according to AHA recommendations.Results. According to the prevalence of CKM syndrome stages, the patients were distributed as follows: 0 stage – 26.38%; 1 stage – 39.26%; 2 stage – 33.75%; 3 stage – 0.61%; 4 stage – 0%. The patients with obesity had significantly higher 10-year and Lifetime ASCVD risk and urinary albumin-creatinine ratio that reflected to G2 KDIGO stage in 15.85%. The prevalence of CKM syndrome stages in obese vs non-obese patients was the following: stage 0 – 21.95% vs 30.86%; stage 1 – 30.49% vs 48.15%; stage 2 – 46.34% vs 20.99%; stage 3 – 1.22% vs 0% respectively.Conclusions. The prevalence of CKM syndrome stages was the following: 0 stage – 26.38%; 1 stage – 39.26%; 2 stage – 33.75%; 3 stage – 0.61%, and 4 stage – 0%. The CKM syndrome was mostly obesity-driven and metabolically-driven with confirmed influence on kidney function, that impact on higher prevalence of CKM syndrome stages 1–2, higher cardiovascular risk and risk of kidney injury progression in patients with obesity. The novel AHA model and recommended assessments need to be incorporated in screening programs. Strengthening integrated, interdisciplinary collaboration that combines primary care, cardiology, endocrinology, and nephrology is essential for reducing the prevalence of CKM syndrome.