International Society of Nephrology International Expert Forum: Exploring the Nexus of Cardiovascular-Kidney-Metabolic Health.

The cardiovascular-kidney-metabolic framework recognizes the interconnected biological, clinical, and societal drivers of cardiovascular disease, chronic kidney disease, diabetes, and obesity. To advance an integrated perspective, aligned with the kidney community focus, the International Society of Nephrology convened an International Expert Forum, bringing together a global and multidisciplinary team of leaders in this field. This meeting report synthesizes key discussions spanning cardiovascular-kidney-metabolic risk stratification, lifestyle interventions, guideline-directed medical therapies, emerging late-stage therapeutics, and models of care delivery. Participants emphasized the importance of early, integrated case finding; long-term, joint kidney-cardiovascular risk assessment; and timely use of evidence-informed therapies to reduce kidney disease progression, kidney failure, and cardiovascular events. Persistent gaps, including therapeutic inertia, fragmented care, and global inequities in access to care, were highlighted, alongside promising multidisciplinary and system-level care models. Emerging therapies targeting residual risk further underscore the need for adaptive implementation strategies. Aligned with the International Society of Nephrology's mission, this forum represents a foundational step toward connecting disciplines, bridging evidence-to-practice gaps, and building global capacity to improve equitable cardiovascular-kidney-metabolic outcomes.