Redefining Cardiometabolic Disease: Expert Consensus on the CardioVascular–Kidney–Liver–Metabolic (CVKLM) Multiorgan Staging
Abstract
Cardiometabolic diseases increasingly manifest as interconnected dysfunction across the heart, vasculature, kidneys, liver, and metabolic system. The global rise in obesity, insulin resistance, and diabetes, together with therapies benefiting multiple organs, has reshaped the epidemiology and understanding of cardiometabolic disease, exposing the limitations of organ-specific or single-stage approaches. The cardioVascular–kidney–liver–metabolic (CVKLM) framework is a multidimensional staging system in which cardiac, vascular, kidney, liver, and metabolic involvement are graded independently from absent to advanced. Analogous to tumour–node–metastasis staging, it provides a standardized language describing disease severity within each organ and its distribution across organs. Rather than replacing existing classifications, CVKLM integrates universal heart failure stages, validated vascular risk assessment, KDIGO chronic kidney disease stratification, contemporary metabolic dysfunction-associated steatotic liver disease (MASLD) and advanced liver disease criteria, and current definitions of diabetes and clinical obesity. Unlike hierarchical frameworks assigning a single overall stage, CVKLM preserves organ-specific information and records coexisting abnormalities across domains. Intended for clinical and research phenotyping and staging rather than as a validated global risk score, it may facilitate systematic recognition of concomitant organ disease, support existing organ-specific diagnostic, referral, and treatment pathways, and provide a standardized taxonomy for observational studies and clinical trials. The prognostic significance of CVKLM profiles, their incremental value beyond established risk tools, and their clinical utility remain to be established. By integrating these domains within a common architecture, CVKLM offers a pragmatic framework spanning the full spectrum of cardiometabolic disease, from preclinical involvement to advanced multiorgan failure.
Related
- Reply to Crespo, J.; Iruzubieta, P. Comment on "Orozco-Beltrán et al. Evaluation, Management and Therapeutic Approach of Cardiovascular-Kidney-Metabolic Syndrome: A Multidisciplinary Delphi Expert Consensus. J. Clin. Med. 2025, 14, 8930".
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BibTeX
@article{baudry2026redefining,
title = {{Redefining Cardiometabolic Disease: Expert Consensus on the CardioVascular–Kidney–Liver–Metabolic (CVKLM) Multiorgan Staging}},
author = {Guillaume Baudry and Jan Biegus and Juan Carlos López-Azor and Biykem Bozkurt and Javed Butler and Marta Cobo-Marcos and Jeroen Dauw and Sven Francque and Nicolas Girerd and Jennifer B Green and Mateusz Guzik and Gracjan Iwanek and Masatake Kobayashi and Peder Langeland Myhre and Marco Metra and Òscar Miró and Wilfried Mullens and Alberto Palazzuoli and Piotr Ponikowski and Claudio Ronco and Patrick Rossignol and Arun Sanyal and Carmine Zoccali and Muthiah Vaduganathan and Harriette van Spall and Faiez Zannad},
journal = {European Journal of Preventive Cardiology},
year = {2026},
month = oct,
doi = {10.1093/eurjpc/zwag563},
url = {https://hal.univ-lorraine.fr/hal-05850638v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Redefining Cardiometabolic Disease: Expert Consensus on the CardioVascular–Kidney–Liver–Metabolic (CVKLM) Multiorgan Staging
AU - Guillaume Baudry
AU - Jan Biegus
AU - Juan Carlos López-Azor
AU - Biykem Bozkurt
AU - Javed Butler
AU - Marta Cobo-Marcos
AU - Jeroen Dauw
AU - Sven Francque
AU - Nicolas Girerd
AU - Jennifer B Green
AU - Mateusz Guzik
AU - Gracjan Iwanek
AU - Masatake Kobayashi
AU - Peder Langeland Myhre
AU - Marco Metra
AU - Òscar Miró
AU - Wilfried Mullens
AU - Alberto Palazzuoli
AU - Piotr Ponikowski
AU - Claudio Ronco
AU - Patrick Rossignol
AU - Arun Sanyal
AU - Carmine Zoccali
AU - Muthiah Vaduganathan
AU - Harriette van Spall
AU - Faiez Zannad
PY - 2026
DA - 2026/10/27
JO - European Journal of Preventive Cardiology
DO - 10.1093/eurjpc/zwag563
UR - https://hal.univ-lorraine.fr/hal-05850638v1
AB - Cardiometabolic diseases increasingly manifest as interconnected dysfunction across the heart, vasculature, kidneys, liver, and metabolic system. The global rise in obesity, insulin resistance, and diabetes, together with therapies benefiting multiple organs, has reshaped the epidemiology and understanding of cardiometabolic disease, exposing the limitations of organ-specific or single-stage approaches. The cardioVascular–kidney–liver–metabolic (CVKLM) framework is a multidimensional staging system in which cardiac, vascular, kidney, liver, and metabolic involvement are graded independently from absent to advanced. Analogous to tumour–node–metastasis staging, it provides a standardized language describing disease severity within each organ and its distribution across organs. Rather than replacing existing classifications, CVKLM integrates universal heart failure stages, validated vascular risk assessment, KDIGO chronic kidney disease stratification, contemporary metabolic dysfunction-associated steatotic liver disease (MASLD) and advanced liver disease criteria, and current definitions of diabetes and clinical obesity. Unlike hierarchical frameworks assigning a single overall stage, CVKLM preserves organ-specific information and records coexisting abnormalities across domains. Intended for clinical and research phenotyping and staging rather than as a validated global risk score, it may facilitate systematic recognition of concomitant organ disease, support existing organ-specific diagnostic, referral, and treatment pathways, and provide a standardized taxonomy for observational studies and clinical trials. The prognostic significance of CVKLM profiles, their incremental value beyond established risk tools, and their clinical utility remain to be established. By integrating these domains within a common architecture, CVKLM offers a pragmatic framework spanning the full spectrum of cardiometabolic disease, from preclinical involvement to advanced multiorgan failure.
SN - 2047-4873
SN - 2047-4881
ER -