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Broadly defined, CRM disease involves multidirectional interactions between metabolic diseases such as type 2 diabetes (T2D), various types of CVD and chronic kidney disease (CKD). T2D confers increased risk for heart failure, which\u2014although well known\u2014has only recently come into focus for treatment, and may differ by ethnicity, whereas atherosclerotic heart disease is a well\u2010established complication of T2D. Many people with T2D also have CKD, with a higher risk in Asians than their Western counterparts. Furthermore, CVD increases the risk of CKD and vice versa, with heart failure, notably, present in approximately half of CKD patients. Molecular mechanisms involved in CRM disease include hyperglycaemia, insulin resistance, hyperactivity of the renin\u2010angiotensin\u2010aldosterone system, production of advanced glycation end\u2010products, oxidative stress, lipotoxicity, endoplasmic reticulum stress, calcium\u2010handling abnormalities, mitochondrial malfunction and deficient energy production, and chronic inflammation. Pathophysiological manifestations of these processes include diabetic cardiomyopathy, vascular endothelial dysfunction, cardiac and renal fibrosis, glomerular hyperfiltration, renal hypoperfusion and venous congestion, reduced exercise tolerance leading to metabolic dysfunction, and calcification of atherosclerotic plaque. Importantly, recognition of the interaction between CRM diseases would enable a more holistic approach to CRM care, rather than isolated treatment of individual conditions, which may improve patient outcomes. Finally, aspects of CRM diseases may differ between Western and East Asian countries such as Japan, a super\u2010ageing country, with potential differences in epidemiology, complications and prognosis that represent an important avenue for future research.<\/jats:p>","DOI":"10.1111\/dom.14829","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T05:33:21Z","timestamp":1659677601000},"page":"2283-2296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":197,"title":["Interconnection between cardiovascular, renal and metabolic disorders: A narrative review with a focus on Japan"],"prefix":"10.1111","volume":"24","author":[{"given":"Takashi","family":"Kadowaki","sequence":"first","affiliation":[{"name":"Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-8149","authenticated-orcid":false,"given":"Hiroshi","family":"Maegawa","sequence":"additional","affiliation":[{"name":"Yasu City Hospital  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-1816","authenticated-orcid":false,"given":"Hirotaka","family":"Watada","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5334-7687","authenticated-orcid":false,"given":"Daisuke","family":"Yabe","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism and Department of Rheumatology and Clinical Immunology Gifu University Graduate School of Medicine  Gifu Japan"},{"name":"Yutaka Seino Distinguished Center for Diabetes Research Kansai Electric Power Medical Research Institute  Kyoto Japan"},{"name":"Preemptive Food Research Center Gifu University Institute for Advanced Study  Gifu Japan"},{"name":"Center for Healthcare Information Technology Tokai National Higher Education and Research System  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-0939","authenticated-orcid":false,"given":"Koichi","family":"Node","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Saga University  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyoaki","family":"Murohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-5170","authenticated-orcid":false,"given":"Jun","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_13_3_1","volume-title":"International Diabetes Federation. 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