The Problem
Cardiovascular-kidney-metabolic syndrome, also known as CKM syndrome, is a complex disorder attributed to a connection among obesity, diabetes, chronic kidney disease (CKD) and cardiovascular disease (CVD).1,2 CKM syndrome affects nearly every major organ in the body and includes two distinct but overlapping conditions: 1) cardiorenal syndrome and 2) cardiometabolic disorder.1
- Cardiorenal syndrome is the interaction between the heart and kidneys in which the condition of the heart affects the kidneys and vice versa.
- Cardiometabolic disease is a condition in which excess fat leads to a series of effects including inflammation, insulin resistance and metabolic impairments, increasing cardiovascular risk.1
While both disorders are well recognized, metabolic dysfunction is a key driver of two-way interactions between the heart and kidney.1 For example, kidney dysfunction increases metabolic risk factors and the development of CVD, especially heart failure.1
The Complex Challenges
CKM syndrome represents a public health emergency. Approximately 90% of US adults have some stage of this condition, which increases the risk for all forms of CVD.1,2 Not surprisingly, CKM syndrome also leads to high healthcare costs for both patients and health systems. Overweight/obesity and its comorbid conditions—significant factors in the development of CKM syndrome—are associated with an estimated $500 billion in annual direct healthcare costs and an additional $1.2 trillion in annual indirect costs due to lost economic productivity.3 While our scientific understanding of CKM syndrome has increased, the number of available treatments has too. These treatments can improve CKM-related outcomes, reduce utilization of healthcare resources and lower related costs, presenting an opportunity for health systems to strengthen CKM health.1
The American Heart Association (AHA) recently highlighted the need to prioritize CKM health and related outcomes. They proposed clinical staging for CKM syndrome, which may aid in reducing disease progression, serves as a call to action to optimize CKM healthcare in the US. Such an effort will require not only increased education and research but also multiple partnerships among clinical entities, policymakers, payers and numerous stakeholders.1
The Success Factors
Changes to clinical workflows and care team composition will also be necessary to support more interdisciplinary care and integrated obesity management.1
Given the impact of CKM syndrome, health systems are best positioned to improve the management of this condition through three different areas:
- Clinical: Health systems are establishing CKM clinics and centers of excellence while recognizing the need for multidisciplinary care. In addition, health systems continue to drive consolidation by acquiring physician practices. In 2024, hospitals or health systems employed 55% of all US physicians.4
- Financial: Health systems focus on improving care quality and reducing costs through quality improvement and value-based initiatives. Quality-focused programs, such as the Hospital Readmissions Reduction Program (HRRP) and the Kidney Health Evaluation for Patients With Diabetes, are upstream-focused to prevent healthcare resource utilization and costs associated with CKM.5,6
- Operational: Key decision-makers in health systems that oversee population health initiatives are at the core of CKM engagement as they implement systemwide treatment pathways and protocols to standardize the care of these populations.
Petauri Kinect’s team of health system experts can offer insights into the evolving CKM market and help refine your health system engagement strategy for CKM-related conditions. In addition, our Networks of Excellence focused on heart health, metabolic dysfunction-associated steatohepatitis (MASH) and CKD exemplify our commitment to CKM health.
We encourage you to stay tuned for future posts in this series that will describe our expertise in the CKM market and delve further into the three health system factors impacting the management of this condition.
The Solution
Petauri Kinect is the only strategic advisory and marketing agency dedicated to health system and therapeutic area dynamics. With our proven process for uncovering opportunities, we act as an extension of your team to build markets and optimize adoption.
Reach out to our therapeutic teams here to schedule a capabilities meeting and take the next step with us!
References
- Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-kidney-metabolic health: A Presidential Advisory from the American Heart Association. Circulation. 2023;148:1606–1635. DOI: 10.1161/CIR.0000000000001184.
- Zhu R, Wang R, He J, et al. Prevalence of cardiovascular-kidney-metabolic syndrome stages by social determinants of health. JAMA Network Open. 2024;7(11):e2445309. doi:10.1001/jamanetworkopen.2024.45309.
- Waters H, Graf M. America’s obesity crisis: the health and economic costs of excess weight. Milken Institute. 2018. Accessed July 1, 2023. https://milkeninstitute.org/sites/default/files/reports-pdf/Mi-Americas-Obesity-Crisis-WEB_2.pdf.
- PAI-Avalere Physician Employment Trends Study 2019-2023. Available at: https://www.physiciansadvocacyinstitute.org/PAI-Research/PAI-Avalere-Study-on-Physician-Employment-Practice-Ownership-Trends-2019-2023#:~:text=Over%20the%20five%2Dyear%20period,and%2031.1%25%20(South). Accessed February 11, 2025.
- Centers for Medicare and Medicaid Services. Hospital Readmissions Reduction Program (HRRP). ms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp#:~:text=The%20program%20supports%20the%20national,knee%20arthroplasty%20(THA/TKA).
- National Committee for Quality Assurance. Kidney Health: A New HEDIS Measure. July 16, 2020. Available at: https://www.ncqa.org/blog/kidneyhealth/. Accessed March 18, 2025.