Cardio-Renal-Metabolic Syndrome in Patients with Chronic Kidney Disease: Relevance of the Problem; Pathogenetic Mechanisms; Diagnostics; Risk Factors; Prognosis; Research and Treatment Perspectives (Literature Review; Clinical Case Description)

Abstract

Introduction. Cardiorenal metabolic syndrome (CRMS) is a complex, multisystem disorder resulting from the intricate interplay between cardiovascular, renal, and metabolic dysfunctions. In individuals with chronic kidney disease (CKD), CRMS markedly elevates the risk of cardiovascular events, progressive kidney function decline, and overall mortality. Despite its clinical relevance, CRMS remains underdiagnosed, and both its pathophysiological mechanisms and management approaches continue to evolve. Accordingly, a thorough and up-to-date synthesis of the available scientific evidence is essential. The aim of the study. To conduct a comprehensive review of current scientific information on the pathogenesis, diagnostic approaches, risk factors, prognosis, and therapeutic perspectives of cardiorenal metabolic syndrome in patients with chronic kidney disease, based on an analysis of the literature and the description of a clinical case. Results. The review identified the key pathophysiological mechanisms underlying CRMS in CKD, including hemodynamic disturbances, neurohormonal activation, chronic inflammation, and endothelial dysfunction. Current diagnostic strategies encompassing both conventional methods and emerging biomarkers were analyzed. Particular emphasis was placed on risk stratification models, prognostic indicators, and therapeutic perspectives, including the use of SGLT2 inhibitors and comprehensive renoprotective approaches. The presented clinical case further illustrated the typical course and management challenges of CRMS in the context of CKD. Conclusions. CRMS in patients with CKD necessitates an interdisciplinary approach to both diagnosis and treatment, incorporating clinical evaluation, laboratory testing, and instrumental diagnostics. Early identification, accurate risk stratification, and the application of modern therapeutic strategies are critical for improving patient outcomes and slowing the progression of the disease.

Keywords

• cardiorenal metabolic syndrome, chronic kidney disease, pathogenesis, prognosis, risk factors, biomarkers, renoprotection