Shawn M. Carter , 2025-04-18 15:25:00
April 18, 2025
3 min read
Key takeaways:
- Men had higher risk for early cardiovascular-kidney-metabolic syndrome than women.
- Adults earning $45,00 to $75,000 had increased risk for early disease-stage cardiovascular-kidney-metabolic syndrome.
BOSTON — The prevalence of cardiovascular-kidney-metabolic syndrome has increased during the past 20 years among U.S. adults, with a drop in the number of adults with no risk factors, data show.
Researchers set out to identify traits that may increase the likelihood of developing cardiovascular-kidney-metabolic (CKM) syndrome for adults aged 18 years or older, as well as mortality. The results were presented at the National Kidney Foundation Spring Clinical Meetings.
“The take-home message is looking at these early stages as an opportunity to intervene now, because we know about preventing progression,” Ana Laura Licon, MS, a programmer/analyst at the University of Michigan School of Public Health, told Healio.
Defining CKM
The researchers defined several distinct stages of CKM including stage 0 with no risk factors; stage 1 with excess or dysfunctional adiposity and early metabolic risk factors, with a BMI greater than 25 kg/m2, large waist circumference or prediabetes; stage 2 with advanced metabolic and cardiovascular conditions and metabolic risk factors such as an eGFR between 30 mL/min/1.73 m2 and 60 mL/min/1.73 m2, as well as albuminuria, diabetes, prediabetes or hypertension. Stage 3 had subclinical CVD with an eGFR less than 30 mL/min/1.73 m2 or CVD risk above 30%. Stage 4 was defined by clinical CVD, congestive heart failure, myocardial infarction or stroke alongside additional comorbidities such as stage 5 CKD.
Data were collected from the National Health and Nutrition Examination Survey between 2001 and 2020. Time trends of were examined by 4-year cohorts.
The prevalence of CKM syndrome increased substantially during 20 years, according to the researchers. There was a decline in the percentage of adults classified as stage 0, correlating with a rising number of adults entering higher disease stages, Licon and colleagues found.
Demographic factors
Demographic factors were associated with CKM risk, according to the findings. Specifically, age, sex, race, income and education were associated with disease stage. For every 5-year increase in age, the odds of early-stage CKM, such as stage 1 or 2, rose by 1.05 and 1.17 for late-stage CKM.
In addition, men and adults from various racial and ethnic backgrounds had higher risks vs. white adults. Men had higher risks, with an early-stage CKM odds ratio of 1.37 for early-stage
CKM and 2.57 for late-stage CKM. Non-Hispanic Black adults had an early-stage CKM odds ratio of 1.91 and late-stage CKM of 2.48.
In addition, behaviors like physical activity levels and smoking status were also associated with CKM risk. Moderate to vigorous exercise was tied to lower CKM rates, while smoking was linked to higher late-stage risk and potential protective factors early on: Moderate activity related to an early-stage CKM odd ratio of 0.96 and late-stage CKM of 0.79. Current smokers had more risk, with late-stage CKM having an odds ratio of 1.44. Additionally, self-reported sleep problems were associated with CKM risk, with early-stage CKM odds ratio at 1.31 and late-stage at 2.1.
Lastly, adults earning $45,00 to $75,000 per year had an early-stage CKM odds ratio of 1.09, and 0.73 in later stages, whereas college graduates had lower overall odds.
In terms of next steps, “what we want to do, is look at the progression from different [disease] stages, which we have not so far,” Jennifer Bragg-Gresham, MS, PhD, associate research scientist at University of Michigan Medical School, told Healio. “We love this new [method], because [while] people have known about this, we are hoping it will bring more attention to how connected kidney disease is to heart disease and metabolic disease.”
Rising CKM rates suggest an opportunity for early detection and management of obesity, CVD and diabetes, Licon and Bragg-Gresham said.
For more information:
Jennifer Bragg-Gresham, MS, PhD, can be reached at jennb@umich.edu.
Ana Laura Licon, MS, can be reached at alicon@umich.edu.
Sources/Disclosures
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Licon AL, et al. Oral poster presentation 266. Presented at: NKF Spring Clinical Meetings; April 9-13, 2025; Boston.
Disclosures:
Licon reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.