Cases Aleix, Broseta Jose Jesus, Marqués Maria, Cigarrán Secundino, Julián Juan Carlos, Alcázar Roberto, Ortiz Alberto
Servei de Nefrologia i Trasplantament Renal, Hospital Clínic, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain.
Servei de Nefrologia i Trasplantament Renal, Hospital Clínic, Barcelona, Spain.
Nefrologia (Engl Ed). 2024 Nov-Dec;44(6):771-783. doi: 10.1016/j.nefroe.2024.11.011. Epub 2024 Dec 6.
The recent conceptualization of the cardiovascular-kidney-metabolic (CKM) syndrome by the American Heart Association (AHA) opens an opportunity for a multidisciplinary and lifelong approach in the risk stratification, early prevention, and treatment of the vicious circle generated by the interaction of cardiovascular, renal and metabolic risk factors and aggravated by the development of cardiovascular diseases (including their full spectrum: heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral arterial disease), chronic kidney disease or type 2 diabetes mellitus, with the excess or dysfunctional adiposity as the trigger. Three publications offer the rational basis of a conceptual decalogue and action plan and a new cardiovascular risk stratification equation since the age of 30 that includes measures of renal function/damage, among others, to promote effective cardiovascular, renal, and metabolic prevention. In Spain, we must leverage this momentum to adapt these new concepts to our reality with greater and improved collaboration between primary care and the specialties involved in CKM syndrome, including the formation of multidisciplinary units for the optimal management using a patient-centred approach.
美国心脏协会(AHA)最近对心血管-肾脏-代谢(CKM)综合征的概念界定,为采用多学科和终身方法进行风险分层、早期预防以及治疗由心血管、肾脏和代谢风险因素相互作用所产生并因心血管疾病(包括其全谱:心力衰竭、心房颤动、冠心病、中风和外周动脉疾病)、慢性肾脏病或2型糖尿病的发展而加剧的恶性循环创造了契机,其中以肥胖过多或功能失调为触发因素。三篇出版物提供了一个概念性十诫和行动计划的理论基础,以及一个自30岁起的新的心血管风险分层方程,该方程纳入了肾功能/损伤等测量指标,以促进有效的心血管、肾脏和代谢预防。在西班牙,我们必须借助这一势头,通过初级保健与参与CKM综合征的各专科之间加强和改善协作,使这些新概念适应我国实际情况,包括组建多学科单位,采用以患者为中心的方法进行优化管理。