Review of Organ Collaborative Protection Strategies Based on CKM Staging: A Multidisciplinary Intervention Model Centered on Dysfunctional Adipose Tissue

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Background Cardiometabolic-kidney (CKM) syndrome represents a growing global health burden, with dysfunctional adipose tissue(DATA) serving as a central pathophysiological hub linking obesity, type 2 diabetes (T2D), and chronic kidney disease (CKD). The escalating prevalence of visceral adiposity (affecting 41.5% of obese populations) necessitates integrated organ protection strategies targeting adipose-driven cardiorenal metabolic dysregulation. Objective:To establish a DATA-centric multidisciplinary intervention model for stage-specific CKM management, integrating adipose pathophysiology, pharmacotherapy, lifestyle modification, and clinical decision support systems (DSS). Methods This review synthesizes evidence from 49 peer-reviewed studies (2023–2025) using PRISMA guidelines. We propose a DATA-centric multidisciplinary framework integrating:Adipocyte pathophysiology​ (inflammatory cytokine release, TGF-β/Smad3 fibrotic signaling).Pharmacotherapy (GLP-1RAs/SGLT2is for weight loss and cardiorenal protection),Lifestyle interventions (nutrition/exercise protocols),Decision support systems (DSS),with eGFR-stratified dosing algorithms.Validation included clinical data from Wuhan Union Hospital demonstrating 37% reduced cardiorenal events(95% CI:29-45) in CKM Stage 3–4 patients under DSS-guided care. Results Key findings reveal:Mechanistic insights: Visceral adipose TGF-β1 release activates cardiac/renal Smad2/3 phosphorylation (3.1-fold ↑ fibrosis risk; P< 0.01), while glucagon-like peptide-1 receptor agonists(GLP-1RAs) reduce body weight by 5-15% and CKD progression by 40% (P< 0.001).Intervention efficacy: DSS-driven dynamic dosing (e.g., 50% SGLT2i reduction at eGFR 15–44 mL/min) prevented electrolyte imbalances in 89% of high-risk patients.Clinical outcomes: DATA-model implementation lowered all-cause mortality by 28% (HR 0.72, 95% CI 0.64–0.81) in CKM Stage 3–4 cohorts. Conclusion The DATA-centric framework enables precision management of CKM syndrome through stage-specific organ protection strategies. Future translation requires validating DSS algorithms in multinational trials and addressing socioeconomic barriers to implementation.

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