Kidney Week

Abstract: SA-PO0386

Association of Cardiovascular-Kidney-Metabolic Burden with CKD in a National US Cohort

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Tahavvori, Amir, Loma Linda University, Loma Linda, California, United States

Amir Tahavvori, MD

• Ebrahimi, Niloufar, Loma Linda University, Loma Linda, California, United States

Niloufar Ebrahimi, MD

• Abdi Pour, Amir, Loma Linda University, Loma Linda, California, United States

Amir Abdi Pour, MD, FASN

Background

Cardiovascular-kidney-metabolic (CKM) syndrome is the overlap of metabolic, cardiovascular, and kidney disease. Although metabolic syndrome likely drive kidney decline, population-level data on CKM stage and CKD risk (Fig.A) are scarce.

Methods

A cross-sectional study using NHANES data from 2017–2018 (cycle1) and 2021–2023 (cycle2) was conducted. Adults aged ≥18 years with CKM were included. Survey-weighted logistic regression estimated associations between CKM stage and CKD, adjusting for age, sex, and cycle. Interactions by cycle and subgroup analyses by age (<65 vs ≥65 years) and sex were performed. P for trend was calculated using the ordinal CKM stage.

Results

A total of 5,169 adults (2,171 from cycle1; 2,998 from cycle2) were included. Compared with participants in the cycle1, those in cycle2 cohort were older (median age 53 vs 50 years, p<0.001). BMI was comparable between cycles (29 vs 30 kg/m², p=0.7), whereas systolic BP (122 vs 125 mmHg, p<0.001) and HbA1c levels (5.75% vs 5.84%, p<0.001) were lower in cycle2. The prevalence of CKD was also reduced in cycle2 (17% vs 21%, p<0.001). CKD prevalence rose with higher CKM stage in both cycles (Fig.B). Relative to CKM Stage 0, Stage 2 was associated with significantly increased odds of CKD (OR 1.45, 95% CI 1.07–1.96), while Stage 3+ demonstrated the strongest association (OR 2.75, 95% CI 1.90–3.98). A dose-response was seen between higher CKM stage and CKD risk (P-trend <0.001). After multivariable adjustment, cycle2 participants had lower CKD odds than cycle1 (OR 0.78, 95% CI 0.64–0.96). The CKM-CKD link was stable over time and across age and sex.

Conclusion

Greater cardiometabolic burden predicted higher CKD odds in all cycles. This link was consistent by age and sex, supporting CKM staging for kidney risk. In cycle2, cardiometabolic burden and CKD prevalence were lower, possibly reflecting better risk factor management.