Cardiovascular-kidney-metabolic (CKM) syndrome connects obesity, diabetes, heart, and kidney disease into one dangerous web.
Heard of heart disease, kidney disease, obesity, and type 2 diabetes? Most likely the answer will be a yes. But, what about cardiovascular-kidney-metabolic (CKM) syndrome?
We’ve all heard about obesity, type 2 diabetes, heart and kidney diseases. They are among the biggest health concerns of all time. But did you know that these conditions are often connected? Many people live with more than one of them, creating a domino effect inside the body.
The term cardiovascular-kidney-metabolic (CKM) syndrome is now used to describe this web of related health issues where the heart, kidneys, and metabolism are all linked.
So, what’s CKM syndrome, and why should we care?
How Does CKM Syndrome Happen?
Think of your heart, kidneys, and metabolism as a team. Each one depends on others to keep the body running. If one organ starts to struggle, the rest must work harder. This eventually causes the whole system to break down.
Cardiovascular-kidney-metabolic (CKM) syndrome sounds too long and complicated? Here’s a simple way to remember it:
- Cardiovascular refers to heart diseases.
- Kidneys refer to kidney diseases.
- Metabolic refers to obesity and type 2 diabetes.
Having obesity means having excess body fat. When the extra body fat builds up, it releases chemicals that cause inflammation. This damages blood vessels, reduces insulin sensitivity, and raises blood pressure and blood sugar levels. Over time, the heart and kidneys take the hit, leading to long-term, irreversible damage.
The kidneys may start to lose their ability to filter waste, causing excess fluid to build up in the body and even high blood pressure. The heart tissues respond by working overtime, growing thicker but less efficient. Eventually, it struggles to pump blood properly – a condition known as heart failure.
Spotting the Signs
CKM syndrome does not happen overnight. Its symptoms can creep up slowly. Keep an eye out for:
- Shortness of breath
- Feeling fatigue or low energy
- Chest pain or tightness
- Swelling in the ankles, feet, or hands
- Frequent urination
- Loss of appetite
- Dry or itchy skin
- Sleep apnoea (Loud snoring)
If these symptoms sound familiar, it’s worth speaking to a doctor for a check-up.
Are You at Risk?
CKM syndrome develops from common lifestyle and health factors. Many people may be at risk without realising it. You are more likely to develop CKM syndrome if you have:
- A larger waistline or excess fats around the abdomen
- Being obese or overweight
- Poorly controlled type 2 diabetes
- High cholesterol
- High blood pressure
- Existing kidney diseases
- Sedentary lifestyle
- Diets high in fats and processed sugars
- Family history
How Do Doctors Diagnose CKM Syndrome?
CKM syndrome affects several organs at once, hence doctors look at a combination of tests rather than just one.
Kidneys:
- eGFR (estimated glomerular filtration rate) – shows how well the kidneys filter blood.
- UACR (urinary albumin-to-creatinine ratio) – checks for proteins in the urine (an early sign of kidney damage).
- Venous bicarbonate level – measures acidity in the blood to detect metabolic imbalance.
Heart:
- ECG (electrocardiogram) – tracks the heart rhythm.
- BNP, NT-proBNP – blood tests to reveal signs of heart strain or failure.
- High-sensitive troponins – blood tests to detect small injuries to heart muscle.
Metabolism:
- Blood sugar level and HbA1c – measure the short-term and long-term blood sugar control.
- Lipid profiles – checks the cholesterol and fat levels.
- Blood pressure – monitors the strain on the heart.
Stages of CKM Syndrome
CKM syndrome is grouped into four stages, depending on how early it is detected. The aim is to spot and treat CKM syndrome early to prevent serious complications.
| Stage | Description |
| 0 | No risk factors for cardiovascular diseases.
|
| 1 |
|
| 2 |
|
| 3 |
|
| 4 | Diagnosed with:
|
Complications of CKM Syndrome
CKM syndrome may lead to serious health complications such as:
- Heart attacks
- Heart failure
- Stroke
- Atrial fibrillation (Irregular heart rhythm)
- Kidney failure
- Disability
- Early death
Key Takeaways
CKM syndrome reminds us that our organs don’t work in isolation – they are all interconnected. Caring for your heart means caring for your kidneys, metabolism and overall health too.
For those with existing health issues, it is important to take your medications regularly, adopt healthy changes in lifestyle habits, and go for regular follow-up checks to minimise the risk of disease progression.
While for healthy individuals, prevention is imperative. Adopt these health tips:
- Limit salt, sugar and fats intake
- Stay active – aim for at least 150 minutes of exercise weekly
- Target for at least 5% weight loss in obese individuals
- Quit smoking
- Limit alcohol intake
- Manage stress
- Go for regular health screenings
References
- What is CKM Syndrome? American Heart Association. Updated on 12 September 2025. https://www.youtube.com/watch?v=MDNBk2ACdV0
- Obesity: The Missing Link in Singapore’s Heart Health Strategy. Medical Channel Asia. Updated: 29 September 2025. https://medicalchannelasia.com/obesity-the-missing-link-in-singapores-heart-health-strategy/
- Cardiovascular-Kidney-Metabolic (CKM) Syndrome. Cleveland Clinic. Updated: 1 February 2024. https://my.clevelandclinic.org/health/diseases/cardiovascular-kidney-metabolic-syndrome
- Introduction to Obstructive Sleep Apnoea. Medical Channel Asia. Updated: 26 September 2024. https://medicalchannelasia.com/introduction-to-obstructive-sleep-apnoea-osa/
- 6 in 10 Singaporeans with Diabetes Have Poor Glucose Control, Survey Finds. Medical Channel Asia. Updated: 11 November 2024. https://medicalchannelasia.com/6-in-10-singaporeans-with-diabetes-have-poor-glucose-control/
- Half A Million in Singapore Affected by Kidney Disease. Medical Channel Asia. Updated: 24 March 2025. https://medicalchannelasia.com/half-a-million-in-singapore-affected-by-kidney-disease/
- Chiadi E. Ndumele, et al. Cardiovasculapr-Kidney-Metabolic Health: A Presidential Advisory from the American Heart Association. Circulation. Oct 2023:148(20). https://www.ahajournals.org/doi/10.1161/CIR.0000000000001184
