Cardiometabolic & Endocrine Scores

Cardiovascular-Kidney-Metabolic (CKM) Syndrome Staging Calculator

Clinical calculation support · Verify results before clinical use

Clinical Assessment

Enter the patient's current clinical findings. The calculator assigns the highest applicable adult CKM stage; it does not calculate a point score.

—Stage
1

Patient Characteristics

Adult staging criteria; patients younger than 18 years are outside this calculator's intended population.

BMI ≥23 kg/m² and waist ≥80 cm (women) / ≥90 cm (men) when yes.
Requires sex selection to apply the correct threshold.
The guideline's Stage 0 definition requires a normal lipid profile; no standalone LDL-C cutoff is specified in Table 4.
2

Metabolic Risk Factors

Enter measured values and known diagnoses. Hypertension thresholds follow the guideline's CKM staging definition.

Used for metabolic syndrome criteria: <40 men; <50 women.
3

Kidney Function

Use persistent abnormalities (at least 3 months) when identifying CKD. eGFR and UACR together determine KDIGO risk category.

A single abnormal eGFR or UACR does not by itself establish chronic kidney disease. Confirm chronicity and clinical context before using the CKD risk category for staging.

4

Subclinical Cardiovascular Disease / Pre-HF

Findings without established clinical cardiovascular disease. Enter only documented investigations.

Enter a result calculated separately using the PREVENT-CVD equation; this tool does not calculate PREVENT risk.

Biomarker thresholds: NT-proBNP ≥125 pg/mL; hs-cTnT ≥14 ng/L (women) or ≥22 ng/L (men); hs-cTnI ≥10 ng/L (women) or ≥12 ng/L (men). An unspecified sex prevents interpretation of sex-specific troponin thresholds.

5

Clinical Cardiovascular Disease

Established clinical disease, not merely risk factors or subclinical imaging findings.

—CKM Stage
Highest applicable adult CKM stage
Complete the required patient information
The result will update automatically as clinical findings are entered.
Criteria identified
  • No assessment performed.

This is a staging aid, not a diagnostic substitute. Verify chronicity, diagnoses, and source measurements in the clinical record.

About CKM Syndrome Staging

Cardiovascular-kidney-metabolic (CKM) syndrome describes the interrelated pathophysiology of metabolic risk factors, chronic kidney disease, and the cardiovascular system. The adult framework classifies patients from Stage 0 to Stage 4 according to the highest stage criterion present.

Adult stage definitions

StageDefinitionMain criteria
0No CKM risk factorsNormal BMI and waist, normoglycemia, normotension, normal lipid profile; no CKD or subclinical / clinical CVD.
1Excess / dysfunctional adiposityBMI ≥25 (≥23 with Asian ancestry), abdominal obesity, or prediabetes; without other metabolic risk factors or CKD.
2Metabolic risk factors and/or CKDHypertension, triglycerides ≥150 mg/dL, metabolic syndrome, T2D, or moderate-to-high-risk CKD.
3Subclinical CVD / risk equivalentSubclinical coronary atherosclerosis, pre-HF, very-high-risk CKD, or PREVENT-CVD 10-year risk ≥20%.
4aClinical CVD, no kidney failureClinical CHD, HF, stroke, PAD, or AF with CKM risk factors / CKD.
4bClinical CVD with kidney failureStage 4 criteria plus chronic eGFR <15 mL/min/1.73 m² or chronic kidney replacement therapy.

Metabolic syndrome definition

Three or more of five criteria: increased waist circumference; triglycerides ≥150 mg/dL; HDL-C <40 mg/dL in men or <50 mg/dL in women; BP ≥130/80 mmHg or antihypertensive medication; and fasting glucose ≥100 mg/dL.

Kidney risk categories used

Moderate-to-high-risk CKD includes G1–G2 with A2–A3, G3a with A1–A2, or G3b with A1. Very-high-risk CKD includes G3a with A3, G3b with A2–A3, or G4–G5. Albuminuria categories: A1 <30, A2 30–<300, A3 ≥300 mg/g.

References

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome.Journal of the American College of Cardiology. 2026;87(22 Suppl):e1889–e2007. Table 4 and Section 3.1. DOI: 10.1016/j.jacc.2026.03.056. Also published in Circulation: DOI 10.1161/CIR.0000000000001453.
Ndumele CE, Neeland IJ, Tuttle KR, et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association.Circulation. 2023;148:1606–1635. DOI: 10.1161/CIR.0000000000001184.
KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.Kidney International. 2024;105(4S):S117–S314. DOI: 10.1016/j.kint.2023.10.018. Kidney risk grouping in this calculator follows the KDIGO heat-map categories reproduced in the 2026 CKM guideline.
Clinical disclaimer: This calculator operationalizes the adult CKM staging criteria in the 2026 AHA/ACC/ADA/ASN guideline. It is not a diagnostic test, a risk score, or a treatment recommendation. Stage assignment depends on accurate clinical diagnoses, stable-state assessment, persistent kidney abnormalities, and valid test results. Use clinical judgment and consult the original guideline where criteria are uncertain. Pediatric staging is not supported by this tool.
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