Renal Replacement Therapy in Cardiovascular-Kidney-Metabolic Syndrome: Challenges for Dialytic Therapies and Kidney Transplantation.

BACKGROUND

Cardiovascular-kidney-metabolic (CKM) syndrome integrates the strong interrelationship among cardiovascular disease, chronic kidney disease (CKD), and metabolic risk factors such as obesity and diabetes.

SUMMARY: Renal replacement therapy (RRT) is considered an essential component of management in advanced CKD. Kidney failure has unique therapeutic and prognostic challenges, particularly with the coexistence of heart failure, ischemic heart disease, and metabolic syndrome. In this review, we aim to evaluate challenges and therapeutic considerations in dialytic therapies and kidney transplantation in patients with CKM syndrome.

KEY MESSAGES: Patients with CKM syndrome undergoing RRT represent a complex and vulnerable population requiring multidisciplinary and individualized management approaches. Optimization of cardiovascular and metabolic risk factors is essential to improve outcomes in dialysis and kidney transplantation settings.