CKD与CKM的相关性研究进展
Research Progress on the Correlation between CKD and CKM
DOI: 10.12677/acm.2026.1693131, PDF,    科研立项经费支持
作者: 戚玉莲, 赵欣蕾:昆明医科大学第二临床医学院,云南 昆明;杨 敏*:昆明医科大学第二附属医院肾脏内科,云南 昆明
关键词: 心血管–肾脏–代谢综合征;慢性肾脏病;心血管疾病;代谢疾病;Cardiovascular-Renal-Metabolic Syndrome; Chronic Kidney Disease; Cardiovascular Diseases; Metabolic Disease
摘要: 心血管–肾脏–代谢(CKM)综合征描述了代谢危险因素、慢性肾病和心血管系统之间复杂的病理生理相互作用,它是一种全身性疾病,会导致多器官功能障碍和心血管不良事件高发。CKM概念的提出为肾脏科的临床实践带来了新的视角和管理模式,肾脏作为CKM发生、发展的核心桥梁,在血流动力学调控、代谢调节和免疫反应中发挥着关键作用,应重视肾脏对心血管和代谢的慢性交互共损效应,深入了解其病理生理机制对早期预防和临床治疗具有重要意义。
Abstract: Cardiovascular-Kidney-Metabolic (CKM) syndrome describes the complex pathophysiological interactions between metabolic risk factors, chronic kidney disease, and the cardiovascular system. It is a systemic disease that leads to multi-organ dysfunction and a high incidence of adverse cardiovascular events. The introduction of the CKM concept has brought new perspectives and management models to clinical nephrology practice. The kidneys play a crucial role as the core bridge in the development of CKM, involved in hemodynamic regulation, metabolic regulation, and immune response. It is important to recognize the chronic reciprocal damage effects of the kidneys on the cardiovascular and metabolic systems, as understanding their pathophysiological mechanisms is significant for early prevention and clinical treatment.
文章引用:戚玉莲, 赵欣蕾, 杨敏. CKD与CKM的相关性研究进展[J]. 临床医学进展, 2026, 16(9): 1004-1012. https://doi.org/10.12677/acm.2026.1693131

参考文献

[1] Ndumele, C.E., Neeland, I.J., Tuttle, K.R., Chow, S.L., Mathew, R.O., Khan, S.S., et al. (2023) A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement from the American Heart Association. Circulation, 148, 1636-1664.
https://doi.org/10.1161/cir.0000000000001186
[2] Legouis, D., Faivre, A., Cippà, P.E. and de Seigneux, S. (2020) Renal Gluconeogenesis: An Underestimated Role of the Kidney in Systemic Glucose Metabolism. Nephrology Dialysis Transplantation, 37, 1417-1425.
https://doi.org/10.1093/ndt/gfaa302
[3] Galindo, R.J., Beck, R.W., Scioscia, M.F., Umpierrez, G.E. and Tuttle, K.R. (2020) Glycemic Monitoring and Management in Advanced Chronic Kidney Disease. Endocrine Reviews, 41, 756-774.
https://doi.org/10.1210/endrev/bnaa017
[4] Opazo-Ríos, L., Mas, S., Marín-Royo, G., Mezzano, S., Gómez-Guerrero, C., Moreno, J.A., et al. (2020) Lipotoxicity and Diabetic Nephropathy: Novel Mechanistic Insights and Therapeutic Opportunities. International Journal of Molecular Sciences, 21, Article 2632.
https://doi.org/10.3390/ijms21072632
[5] Xu, W., Zhu, Y., Wang, S., Liu, J. and Li, H. (2024) From Adipose to Ailing Kidneys: The Role of Lipid Metabolism in Obesity-Related Chronic Kidney Disease. Antioxidants, 13, Article 1540.
https://doi.org/10.3390/antiox13121540
[6] Valdivielso, J.M., Balafa, O., Ekart, R., Ferro, C.J., Mallamaci, F., Mark, P.B., et al. (2021) Hyperkalemia in Chronic Kidney Disease in the New Era of Kidney Protection Therapies. Drugs, 81, 1467-1489.
https://doi.org/10.1007/s40265-021-01555-5
[7] Borrelli, S., Matarazzo, I., Lembo, E., Peccarino, L., Annoiato, C., Scognamiglio, M.R., et al. (2022) Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers. International Journal of Molecular Sciences, 23, Article 6378.
https://doi.org/10.3390/ijms23126378
[8] Yamada, S. and Nakano, T. (2023) Role of Chronic Kidney Disease (CKD)-Mineral and Bone Disorder (MBD) in the Pathogenesis of Cardiovascular Disease in CKD. Journal of Atherosclerosis and Thrombosis, 30, 835-850.
https://doi.org/10.5551/jat.rv22006
[9] Ho, H. and Shirakawa, H. (2022) Oxidative Stress and Mitochondrial Dysfunction in Chronic Kidney Disease. Cells, 12, Article 88.
https://doi.org/10.3390/cells12010088
[10] Samsu, N. (2021) Diabetic Nephropathy: Challenges in Pathogenesis, Diagnosis, and Treatment. BioMed Research International, 2021, Article ID: 1497449.
https://doi.org/10.1155/2021/1497449
[11] Sloan, L. (2024) SGLT2 Inhibitors across the Spectrum of Chronic Kidney Disease: A Narrative Review. Postgraduate Medicine, 136, 801-809.
https://doi.org/10.1080/00325481.2024.2418795
[12] Yeh, T., Tu, K., Wang, H. and Chen, J. (2024) From Acute to Chronic: Unraveling the Pathophysiological Mechanisms of the Progression from Acute Kidney Injury to Acute Kidney Disease to Chronic Kidney Disease. International Journal of Molecular Sciences, 25, Article 1755.
https://doi.org/10.3390/ijms25031755
[13] Scurt, F.G., Ganz, M.J., Herzog, C., Bose, K., Mertens, P.R. and Chatzikyrkou, C. (2023) Association of Metabolic Syndrome and Chronic Kidney Disease. Obesity Reviews, 25, e13649.
https://doi.org/10.1111/obr.13649
[14] De Bhailis, Á.M. and Kalra, P.A. (2022) Hypertension and the Kidneys. British Journal of Hospital Medicine, 83, 1-11.
https://doi.org/10.12968/hmed.2021.0440
[15] Burnier, M. and Damianaki, A. (2023) Hypertension as Cardiovascular Risk Factor in Chronic Kidney Disease. Circulation Research, 132, 1050-1063.
https://doi.org/10.1161/circresaha.122.321762
[16] Dai, Z. and Zhang, X. (2023) Pathophysiology and Clinical Impacts of Chronic Kidney Disease on Coronary Artery Calcification. Journal of Cardiovascular Development and Disease, 10, Article 207.
https://doi.org/10.3390/jcdd10050207
[17] Szlagor, M., Dybiec, J., Młynarska, E., Rysz, J. and Franczyk, B. (2023) Chronic Kidney Disease as a Comorbidity in Heart Failure. International Journal of Molecular Sciences, 24, Article 2988.
https://doi.org/10.3390/ijms24032988
[18] Banerjee, D., Rosano, G. and Herzog, C.A. (2021) Management of Heart Failure Patient with CKD. Clinical Journal of the American Society of Nephrology, 16, 1131-1139.
https://doi.org/10.2215/cjn.14180920
[19] Akhtar, Z., Leung, L.W., Kontogiannis, C., Chung, I., Bin Waleed, K. and Gallagher, M.M. (2022) Arrhythmias in Chronic Kidney Disease. European Cardiology Review, 17, e05.
https://doi.org/10.15420/ecr.2021.52
[20] Gadde, S., Kalluru, R., Cherukuri, S.P., Chikatimalla, R., Dasaradhan, T. and Koneti, J. (2022) Atrial Fibrillation in Chronic Kidney Disease: An Overview. Cureus, 14, e27753.
[21] Rossing, P., Caramori, M.L., Chan, J.C.N., Heerspink, H.J.L., Hurst, C., Khunti, K., et al. (2022) KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International, 102, S1-S127.
https://doi.org/10.1016/j.kint.2022.06.008
[22] Lin, L., Tan, W., Pan, X., Tian, E., Wu, Z. and Yang, J. (2022) Metabolic Syndrome-Related Kidney Injury: A Review and Update. Frontiers in Endocrinology, 13, Article ID: 904001.
https://doi.org/10.3389/fendo.2022.904001
[23] Jiang, Z., Wang, Y., Zhao, X., Cui, H., Han, M., Ren, X., et al. (2023) Obesity and Chronic Kidney Disease. American Journal of Physiology-Endocrinology and Metabolism, 324, E24-E41.
https://doi.org/10.1152/ajpendo.00179.2022
[24] Lee, L.E., Doke, T., Mukhi, D. and Susztak, K. (2024) The Key Role of Altered Tubule Cell Lipid Metabolism in Kidney Disease Development. Kidney International, 106, 24-34.
https://doi.org/10.1016/j.kint.2024.02.025
[25] Mei, Y., Dong, B., Geng, Z. and Xu, L. (2022) Excess Uric Acid Induces Gouty Nephropathy through Crystal Formation: A Review of Recent Insights. Frontiers in Endocrinology, 13, Article ID: 911968.
https://doi.org/10.3389/fendo.2022.911968
[26] Timsans, J., Palomäki, A. and Kauppi, M. (2024) Gout and Hyperuricemia: A Narrative Review of Their Comorbidities and Clinical Implications. Journal of Clinical Medicine, 13, Article 7616.
https://doi.org/10.3390/jcm13247616
[27] 李铭, 郑冉, 丛岩, 等. 心血管-肾脏-代谢综合征的最新研究进展[J]. 心血管病学进展, 2025, 46(7): 614-618.
[28] 夏经钢, 袁明霞, 蔡晓凌, 等. 心血管-肾脏-代谢综合征患者的综合管理中国专家共识[J]. 中国心血管病研究, 2025, 23(3): 193-228.
[29] 缪丽云. DASH饮食配合个性化运动行为干预对老年高血压患者血压控制、身体及生活质量、心血管不良事件的影响[J]. 中西医结合心血管病电子杂志, 2022, 10(31): 42-45.
[30] 康其乐. 地中海饮食与代谢综合征的关系: 基于NHANES数据库2007-2020 [D]: [硕士学位论文]. 南昌: 南昌大学, 2025.
[31] Luna-Marco, C., Iannantuoni, F., Hermo-Argibay, A., Devos, D., Salazar, J.D., Víctor, V.M., et al. (2024) Cardiovascular Benefits of SGLT2 Inhibitors and GLP-1 Receptor Agonists through Effects on Mitochondrial Function and Oxidative Stress. Free Radical Biology and Medicine, 213, 19-35.
https://doi.org/10.1016/j.freeradbiomed.2024.01.015
[32] 殷钰喆, 李喆, 吴永健. 心血管-肾脏-代谢综合征视角下动脉粥样硬化性心血管疾病的现状与管理策略[J]. 心血管病学进展, 2025, 46(4): 289-293.
[33] Huang, J., Mao, Y., Zhao, X., Liu, Q. and Zheng, T. (2023) Association of Anxiety, Depression Symptoms and Sleep Quality with Chronic Kidney Disease among Older Chinese. Medicine, 102, e35812.
https://doi.org/10.1097/md.0000000000035812
[34] Beurel, E., Toups, M. and Nemeroff, C.B. (2020) The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron, 107, 234-256.
https://doi.org/10.1016/j.neuron.2020.06.002