Abstract
Cardiovascular-kidney-metabolic (CKM) syndrome is a systemic abnormality resulting from complex pathophysiological interactions among cardiovascular disease, chronic kidney disease, and metabolic risk factors, particularly diabetes mellitus and obesity. In clinical practice, the management of CKM syndrome encounters some significant challenges, including the lack of clinicians’ knowledge regarding the most up-to-date therapy, limited drug availability, and restrictions on health insurance. Those issues potentially lead to a rise in morbidity and mortality rates of patients with CKM syndrome. This article elucidates the most updated concept of CKM syndrome regarding its pathophysiology, diagnostic approach, and treatment based on clinical stages ranging from stage 0 to stage 4. Some emerging medications have proven to improve the prognosis of patients with CKM syndrome by targeting any of the pathophysiological interactions, namely sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, angiotensin-enzyme converting inhibitors, and angiotensin receptor blockers. Recent studies have proven their efficacy in reducing hospitalisation rates and cardiovascular-related mortality. Not only by applying current clinical guidelines in practice, CKM syndrome should also be managed holistically in a multidiscipline manner starting from health promotion to curative treatment. Hence, the current concept of CKM syndrome pointing to holistic and multidiscipline management hopefully could prevent the progressivity of the disease and reduce the morbidity and mortality rates.
Bahasa Abstract
Sindrom kardiovaskular-ginjal-metabolik (KGM) adalah kelainan sistemik yang dihasilkan dari interaksi patofisiologi kompleks antara penyakit kardiovaskular, penyakit ginjal kronik, dan faktor risiko metabolik, terutama diabetes melitus dan obesitas. Pada praktik klinis, manajemen sindrom tersebut menemui sejumlah tantangan signifikan, mencakup kurang meratanya pengetahuan klinisi terkait terapi terkini, keterbatasan obat, atau pun keterbatasan dalam pembiayaan kesehatan. Permasalahan tersebut berpotensi meningkatkan tingkat morbiditas dan mortalitas dari sindrom KGM. Artikel ini menjelaskan konsep terkini dari sindrom KGM yang berfokus pada patofisiologi, pendekatan diagnostik, dan manajemen berdasarkan stadium klinis dari stadium 0 hingga stadium 4. Sejumlah obat saat ini diketahui mampu memperbaiki prognosis penyakit dengan menghambat salah satu proses patofisiologi pada sindrom KGM, seperti sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, angiotensin-enzyme converting inhibitors, dan angiotensin receptor blockers. Studi membuktikan bahwa obat-obatan tersebut mampu menurunkan risiko hospitalisasi dan tingkat mortalitas kardiovaskular. Selain menerapkan terapi berdasarkan konsep terkini, manajemen sindrom KGM juga harus dilaksanakan secara holistik dan multidisiplin, mulai dari promosi kesehatan hingga tata laksana kuratif. Dengan demikian, konsep sindrom KGM terkini yang menekankan pada manajemen holistik dan multidisiplin diharapkan mampu mencegah progresivitas penyakit serta menurunkan tingkat morbiditas dan mortalitas.
Kata Kunci: Diabetes melitus, penyakit ginjal kronik, penyakit kardiovaskular, sindrom metabolik
Recommended Citation
Yamin, Muhammad and Putra, Harits Adi
(2024)
"Sindrom Kardiovaskular-Ginjal-Metabolik: Konsep Terkini untuk Klinisi,"
Jurnal Penyakit Dalam Indonesia: Vol. 11:
Iss.
2, Article 9.
DOI: 10.7454/jpdi.v11i2.1597
Available at:
https://scholarhub.ui.ac.id/jpdi/vol11/iss2/9
