{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:27:08Z","timestamp":1791552428060,"version":"4.3.4"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Our study aims to analyze the relationship between different stage of Cardiovascular-Kidney-Metabolic (CKM) Syndrome in Chronic Kidney Disease (CKD) patients and the risk of progression to all-caused mortality or end-stage renal disease (ESRD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed by collecting baseline data of CKD patients. All participants were followed throughout the course of the study. Cox proportional hazards analysis and Fine-Gray subdistribution model was performed to analyze the prognostic value of different CKM stages on the risk of adverse clinical outcomes (all-caused mortality or progression to ESRD) of these patients. 1,358 patients finally completed the follow-up. Among them, 1,233 patients were alive, and 125 patients had died; and 163 patients progressed to ESRD. Baseline CKM stage 3 (OR=3.906, 95% CI=0.988-16.320, p=0.048) and stage 4 (OR=5.728, 95% CI=1.329-24.698, p=0.019) remain independent risk factors for all-cause mortality in CKD patients, while CKM stage 2b (OR=2.739, 95% CI=1.157-6.486, p=0.022) were identified as having an independent risk factor for progression to ESRD in CKD patients by adjusting confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our research demonstrated that a high-risk CKM stage can predict adverse clinical outcomes in CKD patients, including all-cause mortality and progression to ESRD.<\/jats:p>\n                  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