Heart disease, kidney disease and Type 2 diabetes are often discussed as separate health conditions. But medical experts increasingly recognize that these diseases are deeply connected -- and when they occur together, they can create a cycle that significantly increases the risk of serious complications.
The relationship is so significant that health care providers now use a specific term to describe it: cardio-kidney-metabolic (CKM) syndrome.
CKM syndrome describes the interconnected relationship between cardiovascular disease, chronic kidney disease, diabetes, obesity and other metabolic disorders. When one condition develops or worsens, it can place added stress on the others, accelerating disease progression throughout the body.
How CKM syndrome affects the body
“Type 2 diabetes is extremely common in our community and affects more than blood glucose,” said Dr. Shweta Bansal, a nephrologist with University Health. “In one in three patients, diabetes damages kidneys, injuring the blood vessels that filter excess water and waste. Diabetes also significantly increases the risk of heart disease, and when all three conditions occur together, they’re not operating in isolation -- they make each other worse.”
A patient with diabetes may develop kidney disease, which can increase the risk of heart failure and other cardiovascular complications. Obesity and metabolic disorders can further accelerate the progression of both kidney and heart disease.
Because these conditions influence one another, treating a single diagnosis without considering the others does not fully address a patient’s overall health risks.
Why coordinated care matters
Despite how closely linked these conditions are, treatment has traditionally been divided among multiple specialists.
A patient might see a cardiologist for heart disease, a nephrologist for kidney disease and an endocrinologist for diabetes management. While each specialist plays an important role, coordinating medications, treatment plans and follow-up care across multiple providers can be challenging.
A team-based approach to treatment
“We call it cardio-kidney-metabolic syndrome,” Bansal said. “But very often, we treat these conditions separately, resulting in fragmented care and delayed treatment. That’s why we created the Cardio-Kidney-Metabolic Clinic, where specialists work together to treat patients as a whole.”
University Health’s recently established Cardio-Kidney-Metabolic Clinic combines expertise from cardiology, nephrology and endocrinology to develop integrated treatment plans. The multidisciplinary team also includes clinical pharmacists, dietitians, social workers and care coordinators who help address both medical and non-medical factors that can affect health outcomes.
For patients with complex chronic conditions, that collaboration can be especially important because treatments that benefit one system can negatively affect another.
Looking beyond the diagnosis
The clinic focuses on helping patients manage heart failure, coronary artery disease, chronic kidney disease, hypertension, obesity and diabetes while reducing the risk of complications, hospitalizations and disease progression.
In addition to medical treatment, the clinic addresses barriers that can make chronic disease management more difficult, including medication access, transportation, insurance and nutrition needs.
The approach reflects a broader shift in medicine toward treating CKM syndrome as a connected disease process rather than a collection of separate diagnoses.
When to talk to your doctor
For patients living with diabetes, heart disease, kidney disease or multiple related risk factors, experts say understanding those connections is an important first step.
“Talk to your primary care physician if you might have cardio-kidney-metabolic syndrome,” Bansal said.
Patients who need specialized care can work with the multidisciplinary team at University Health’s Cardio-Kidney-Metabolic Clinic to develop a coordinated treatment plan designed to support long-term heart, kidney and metabolic health.