Inflammation in cardiovascular-kidney-metabolic syndrome: key roles and underlying mechanisms-a comprehensive review.

Abstract

Cardiovascular-Kidney-Metabolic (CKM) syndrome, a newly defined systemic disorder, is characterized by the pathological interplay among diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD). Recent studies have identified chronic inflammation not only as a central mediator in the pathological progression of CKM syndrome but also as a pivotal molecular hub that drives coordinated damage across multiple organ systems. Mechanistic investigations have revealed that aberrant activation of signaling pathways such as NF-κB, Wnt, PI3K-AKT, JAK-STAT, and PPAR constitutes a complex inflammatory regulatory network. Notably, these pathways facilitate inter-organ inflammatory crosstalk, establishing positive feedback loops among the heart, kidneys, and metabolic tissues. This, in turn, amplifies pathological processes such as oxidative stress, endothelial dysfunction, and fibrosis in a cascading manner.This review systematically delineates the multidimensional pathophysiological mechanisms of CKM syndrome, with particular emphasis on the inter-organ inflammatory regulation mediated by key signaling pathways. Furthermore, we explore the translational potential of therapeutic strategies targeting inflammatory cytokines (e.g., IL-1β, IL-6, and TNF-α) based on the latest clinical evidence, aiming to provide a theoretical framework and novel perspectives for disrupting the vicious cycle of CKM syndrome.