Prevalence of cardio-kidney-metabolic syndrome and missed opportunities for guideline-directed medical therapy among chronic kidney disease patients at a Malaysian Tertiary centre

Cardio-Kidney-Metabolic (CKM) syndrome describes the intertwined burden of cardiovascular, renal, and metabolic disorders. While the American Heart Association’s 2023 framework highlights its global importance, data from Southeast Asia remain scarce. Guideline-directed medical therapies (GDMT)— statins, SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists (ns-MRAs), and GLP- 1 receptor agonists—are proven to reduce cardio-renal events, yet real-world use among CKD patients is uncertain.