{ "abstract": "Cardiovascular–kidney–metabolic (CKM) syndrome is driven by the interplay of visceral adiposity, insulin resistance, chronic inflammation, oxidative stress, and progressive kidney dysfunction. These mechanisms generate a distinct atherogenic dyslipidaemic phenotype characterised by elevated triglycerides (TG), reduced high-density lipoprotein-cholesterol (HDL-C), increased apolipoprotein B (apoB)-containing lipoproteins, remnant cholesterol (RC) accumulation, small dense low-density lipoprotein (LDL) particles, and frequently elevated lipoprotein(a) [Lp(a)]. Such lipid abnormalities contribute to accelerated atherosclerosis and early renal deterioration. In turn, kidney dysfunction further amplifies lipid abnormalities. These pathways underscore the need for a timely and comprehensive lipid assessment using apoB, non-HDL-C, RC, and Lp(a) within the CKM framework. Effective lipid management is crucial for CKM syndrome treatment, with the potential to reduce residual cardiovascular and renal risk and improve long-term clinical outcomes. In this narrative review, we examine current evidence on the pathophysiological mechanisms underlying CKM-related dyslipidaemia and provide a practical framework for its assessment and management. Management requires a multimodal approach tailored to the patient’s lipid phenotype and overall cardiovascular risk, incorporating a range of lipid-lowering strategies including statins, ezetimibe, PCSK9 inhibitors, bempedoic acid, fibrates, icosapent ethyl, and emerging therapies targeting apoC-III, ANGPTL3, and Lp(a). Beyond lipid lowering, lifestyle interventions and cardiometabolic therapies such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, and finerenone may provide complementary cardiometabolic and renal protection.", "abstract_shown": true, "affiliations": [ "Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania", "Department of Cardiology, Thoraxcentrum, Erasmus MC, 3015 CE Rotterdam, The Netherlands", "Department of Internal Medicine, Yavuzeli District State Hospital, 27907 Gaziantep, Türkiye", "Department of Nephrology, Hacettepe University, 06800 Ankara, Türkiye", "State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 04114 Kyiv, Ukraine", "Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy", "Department of Internal Medicine, Cantonal Hospital Zenica, 72000 Zenica, Bosnia and Herzegovina", "University of Zenica, 72000 Zenica, Bosnia and Herzegovina", "Department of Nursing, Ryazan State Medical University, 390026 Ryazan, Russia", "Department for Invasive and Interventional Cardiology, City General Hospital “8th of September”, 1000 Skopje, North Macedonia", "Department of Cardiology, Suşehri District State Hospital, 58600 Sivas, Türkiye", "The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK", "Cardiovascular Center Aalst, 9300 Aalst, Belgium", "Department of Prevention and Treatment of Emergency Conditions, L.T. Malaya Therapy National Institute NAMSU, 61039 Kharkiv, Ukraine", "Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece", "Department of Respiratory Medicine and Allergology, State University of Medicine and Pharmacy “Nicolae Testemitanu”, 2004 Chisinau, Moldova", "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark", "Copenhagen Respiratory Research, Department of Medicine, Copenhagen University Hospital—Herlev and Gentofte, DK-2900 Copenhagen, Denmark", "Remedical Hospital, 9/16’ Tsinandali Str., 1044 Tbilisi, Georgia", "Georgian Atherosclerosis Association, 9’ L. Managadze Str., 0144 Tbilisi, Georgia", "Weill Medical College, Cornell University, New York, NY 10065, USA" ], "article_type": null, "arxiv": null, "author_total": 18, "authors": [ { "affs": [ 0 ], "name": "Alexandr Ceasovschih", "orcid": "0000-0002-0043-9051" }, { "affs": [ 1, 2 ], "name": "Yusuf Ziya Şener", "orcid": "0000-0001-5151-5133" }, { "affs": [ 3 ], "name": "Mustafa Arici" }, { "affs": [ 4 ], "name": "Mariia Cherska" }, { "affs": [ 5 ], "name": "Vanessa Bianconi" }, { "affs": [ 6, 7 ], "name": "Malik Ejubović", "orcid": "0000-0003-1583-6567" }, { "affs": [ 8 ], "name": "Stanislav Kotlyarov", "orcid": "0000-0002-7083-2692" }, { "affs": [ 9 ], "name": "Vladimir Ristovski", "orcid": "0009-0001-1327-1059" }, { "affs": [ 10 ], "name": "Ahmet Yetkin", "orcid": "0000-0003-1907-5355" }, { "affs": [ 11 ], "name": "Pelin Golforoush", "orcid": "0000-0002-7543-4167" }, { "affs": [ 12, 13 ], "name": "Tatyana Storozhenko", "orcid": "0000-0002-9158-2012" }, { "affs": [ 14 ], "name": "Fotios Barkas", "orcid": "0000-0002-5940-6895" }, { "affs": [ 15 ], "name": "Alexandru Corlateanu", "orcid": "0000-0002-3278-436X" }, { "affs": [ 16, 17 ], "name": "Pradeesh Sivapalan", "orcid": "0000-0002-8620-3655" }, { "affs": [ 18, 19 ], "name": "Tea Gamezardashvili", "orcid": "0000-0002-9839-0718" }, { "affs": [ 20 ], "name": "Antonio M. Gotto" }, { "affs": [ 0 ], "name": "Laurentiu Sorodoc" }, { "affs": [ 0 ], "name": "Victorita Sorodoc" } ], "bibtex": "https://research.draconitic.com/paper/a09scahetzv2m.bib", "cited_by": 0, "doi": "10.3390/ijms27188317", "fulltext_url": null, "id": "a09scahetzv2m", "issns": [ "1422-0067" ], "landing_url": "https://www.mdpi.com/1422-0067/27/18/8317", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2746|Lipoproteins and Cardiovascular Health" ] ], "openalex": "W7214469925", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-09-18", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/a09scahetzv2m.ris", "sources": [ { "first_seen": "2026-10-30T12:18:55Z", "native_id": "10.3390/ijms27188317", "source": "crossref", "url": "https://www.mdpi.com/1422-0067/27/18/8317" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2746|Lipoproteins and Cardiovascular Health", "subfield": "surgery" } ], "title": "Features of Lipid Disorders in Cardiovascular–Kidney–Metabolic Syndrome", "title_text": "Features of Lipid Disorders in Cardiovascular–Kidney–Metabolic Syndrome", "type": "peer-reviewed", "updated_at": "2026-10-30T12:18:55Z", "url": "https://research.draconitic.com/paper/a09scahetzv2m", "venue": "International Journal of Molecular Sciences", "versions": [] }