Heart, Kidney & Metabolic Care: A Strategic Imperative for Health Systems

For U.S. healthcare systems, clinical and financial stability can be achieved when we look beyond treatment options for individual disease states and instead take a more holistic approach that also addresses the pathological mechanisms that extend across multiple disease states.

The American Heart Association definition of the cardiovascular-kidney-metabolic syndrome (CKM syndrome), a systemic overlap of heart disease, kidney disease, diabetes and obesity, is one important step in advancing integrated care. According to the American Heart Association, nearly nine out of 10 U.S. adults have at least one of the risk factors that make up CKM syndrome, but most people have not heard of CKM syndrome and don’t know how closely these health issues are connected.

This knowledge gap highlights a critical blind spot in American healthcare. The result is a tidal wave of preventable adverse health outcomes — from undiagnosed hypertension to end stage kidney disease — that are often first identified during a hospitalization rather than being proactively identified and treated in outpatient care settings.

By treating conditions like heart disease and diabetes early and together, providers can proactively help manage risks to support healthier futures for their patients.

Breaking the Cycle of Siloed Care

Cardiovascular, kidney and metabolic conditions don’t progress independently — they compound each other. Risk accumulates across systems, not solely within the purview of a given specialty. When care is fragmented, these compounding risks can go unmanaged. Conversely, when care is integrated, these risks can be addressed earlier, more effectively and at lower cost.

This clinical reality is what makes integrated care uniquely powerful for CKM health. Models that treat cardiac care, kidney care and metabolic care in tandem are not simply better coordinated — they are structurally better suited to manage shared risk, intervene earlier and prevent downstream complications.

“CKM conditions don’t exist in silos, and care shouldn’t either,” says Michael O’Shea, MD, vice president for DaVita Integrated Kidney Care. “When we address comorbid conditions together — rather than one at a time — we create better outcomes for patients and more sustainable systems of care.”

When care teams take a cohesive, interdisciplinary approach, they can unlock three critical advantages:

  • Precise Risk Stratification: Breaking down data silos to view comorbidities holistically, enabling more accurate identification of potential adverse events.
  • Optimized Therapeutics: Leveraging earlier identification to initiate organ-protective therapies (e.g., SGLT2 inhibitors, GLP-1 RAs) that offer multi-system benefits and help slow disease progression.
  • Reduced Total Cost of Care: Mitigating the clinical and financial burden of downstream complications, including end stage kidney disease (ESKD) or heart failure.

Taking Action: The American Heart Association’s CKM Health Initiative

Accelerating this shift requires system-wide standardization. To further establish integrated care from concept to practice, the American Heart Association launched its groundbreaking CKM Health Initiative.

Sponsored by DaVita and other industry leaders, this four-year effort offers clinicians evidence-based tools to help operationalize new standards:

  • Goal: Establish best practices for interdisciplinary care impacting 250,000+ patients.
  • Focus: Implementing evidence-based guidelines to bridge the gap between specialty practices.
  • Scope: 150 healthcare sites across 15 regions.

“Expanding access to integrated care is an imperative,” says Dr. O’Shea. “The American Heart Association’s initiative provides health systems with a framework and equips clinicians with actionable, cross-specialty insights to help drive more precise interventions and support improved population health outcomes.”

3 American Heart Association Tools for Clinicians

The American Heart Association offers evidence-based tools to help clinicians implement integrated CKM care models:

DaVita is a Champion Sponsor of the American Heart Association’s Cardiovascular-Kidney-Metabolic (CKM) Health Initiative.

A woman sits in a chair next to a dialysis machine as she smiles up at a caregiver who is offscreen

How DaVita is Broadening Access to Integrated Care

Integrated care relies on robust
infrastructure, advanced technology and a reimagined clinical culture. DaVita is working to bridge care gaps through key innovations and investments: