Evidence map›Paper›PMID 42684397›Full record

GuidelineJournal of the American Society of Nephrology : JASN2026

ASN Kidney Health Guidance on the Cardiovascular-Kidney-Metabolic Syndrome.

Nisha Bansal, Petter Bjornstad, Adam P Bress, Tara I Chang, Xingxing Cheng, Michelle M Estrella, Alan S Go, Amy K Mottl, Sankar D Navaneethan, Brendon L Neuen and 4 more

Abstract readPractice Guideline
In one paragraph

Guideline in Journal of the American Society of Nephrology : JASN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nisha BansalDivision of Nephrology, University of Washington, Seattle, Washington.ORCID 0000-0002-9583-8628
Petter BjornstadDivision of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, Washington.ORCID 0000-0002-5160-2947
Adam P BressPopulation Health Sciences, University of Utah, Salt Lake City, Utah.
Tara I ChangStanford Division of Nephrology, Department of Medicine, Stanford University, Stanford, California.ORCID 0000-0002-4691-1681
Xingxing ChengStanford Division of Nephrology, Department of Medicine, Stanford University, Stanford, California.ORCID 0000-0002-0542-8749
Michelle M EstrellaRenal Section, San Francisco VA Health Care System, Kidney Health Research Collaborative, University of California San Francisco, San Francisco, California.ORCID 0000-0002-8902-9576
Alan S GoDivision of Research (Cardiovascular, Kidney and Metabolic Health), Solutions Through Technology and Advanced Analytics Research (STAR) Group, Kaiser Permanente Northern California, Oakland, California.ORCID 0000-0001-9109-0811
Amy K MottlDivision of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina.ORCID 0000-0002-4258-1726
Sankar D NavaneethanSection of Nephrology and Institute of Clinical and Translational Research, Baylor College of Medicine and Renal Section, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.ORCID 0000-0002-4953-7795
Brendon L NeuenThe George Institute for Global Health, Royal North Shore Hospital, University of Sydney, UNSW Sydney, Sydney, Australia.ORCID 0000-0001-9276-8380
Brian S RifkinHattiesburg Clinic, Hattiesburg, Mississippi.ORCID 0000-0001-8395-3744
Kim ZuberAmerican Academy of Nephrology Physician Assistants, Melbourne, Florida.
Alexander R ChangDepartment of Nephrology, Geisinger, Danville, Pennsylvania.ORCID 0000-0002-8114-7447
on behalf of the ASN Kidney Health Guidance Workgroup on the Cardiovascular-Kidney-Metabolic Syndrome

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

key pointsThe cardiovascular-kidney-metabolic (CKM) syndrome framework has important implications in the care of people with kidney diseases. Cardiovascular screening is important in people with kidney diseases, but the approach may differ in this high-risk population. Multiple pharmacotherapies for CKM syndrome offer significant cardiovascular and kidney benefits. Cardiovascular-kidney-metabolic (CKM) syndrome highlights the interconnected nature of cardiovascular disease, CKD, and metabolic dysfunction and underscores the need for integrated approaches to prevention and treatment. Patients with kidney diseases are at markedly elevated risk for atherosclerotic cardiovascular events, heart failure, kidney failure, and premature mortality across the spectrum of kidney disease severity. Recent advances in therapeutics, including sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1)-based therapies, and nonsteroidal mineralocorticoid receptor antagonists, alongside established renin-angiotensin system inhibitors and lipid-lowering therapies, have transformed the management of CKM by demonstrating both cardiovascular and kidney benefits. However, important gaps remain in applying the CKM framework to patients with kidney diseases, particularly among individuals with advanced CKD, kidney failure treated with dialysis, kidney transplant recipients, younger and older individuals, and those with nonmetabolic kidney diseases including glomerular disorders. This American Society of Nephrology Kidney Health Guidance provides practical guidance for nephrology clinicians on screening, risk stratification, and pharmacologic management across the CKM spectrum. The guidance emphasizes the importance of longitudinal assessment of estimated glomerular filtration rate and albuminuria as foundational markers of cardiovascular and kidney risk, including the role of cardiac biomarkers and imaging. Integration of cardiovascular and kidney risk prediction models, including the American Heart Association Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations and the Kidney Failure Risk Equation (KFRE), may support early identification of high-risk patients and guide treatment intensification. The guidance also reviews evidence supporting sequential and combination approaches to CKM therapies, strategies for managing adverse effects, and special considerations for CKD subpopulations where data are more limited. Adoption of a CKM framework in nephrology practice promotes coordinated, multidisciplinary care and provides an opportunity to shift from organ-specific management toward a more holistic approach aimed at reducing cardiovascular events, slowing kidney disease progression, and improving patient-centered outcomes across the continuum of kidney disease. PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3//www.asn-online.org/media/podcast/JASN/2026_09_02_KTS_September2026.mp3.

Indexed as

Cardio-Renal SyndromeCardiovascular DiseasesMetabolic SyndromeRenal Insufficiency, ChronicHumansReview Literature as Topiccardiovascular-kidney-metabolic (CKM) syndromeCKDglomerular diseasestransplant outcomes

Identifiers

PMID42684397
PMCPMC13641481

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.