Author information

¹Metabolic Institute of America, Tarzana, CA, USA. Electronic address: yhandelsman@gmail.com.

²The Frist Clinic, Nashville, TN, USA.

³University of Chicago Medicine, Chicago, IL, USA.

⁴Department of Medicine, Baylor College of Medicine, Texas Heart Institute, Houston, TX, USA.

⁵Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, NY, New York, USA.

⁶Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, NY, New York, USA.

⁷Department of Medicine, Baylor College of Medicine, Houston, TX, USA.

⁸David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.

⁹University of Mississippi Medical Center, Jackson, MS, USA.

¹⁰Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.

¹¹University of Texas Health Science Center, San Antonio, TX, USA.

¹²Interdisciplinary Research Center "Health Science", Sant'Anna School of Advanced Studies, Pisa, Italy.

¹³University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

¹⁴Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece.

¹⁵Tulane University Health Sciences Center, New Orleans, LA, USA.

¹⁶University of Alabama at Birmingham, Birmingham, AL, USA.

¹⁷Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy.

¹⁸University of Leeds, Leeds, United Kingdom.

¹⁹Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA.

²⁰Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.

²¹Department of Nephrology, University of Helsinki, Finnish Institute for Health and Helsinki University HospitalWelfare, Folkhälsan Research Center, Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia.

²²Grunberger Diabetes Institute, Bloomfield Hills, MI, USA; Wayne State University School of Medicine, Detroit, MI, USA; Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Charles University, Prague, Czech Republic.

²³Yale University School of Medicine, New Haven, CT, USA.

²⁴The Center for Diabetes & Endocrine Care, University of Miami Miller School of Medicine, Hollywood, FL, USA.

²⁵University of Leicester, Leicester, United Kingdom.

²⁶Washington University School of Medicine, Saint Louis, MO, USA.

²⁷Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.

²⁸University of California at Irvine, Irvine, CA, USA.

²⁹St. Michael's Hospital, University of Toronto, Toronto, Canada.

³⁰Harvard Medical School, Boston University School of Medicine, Boston, MA, USA.

³¹Department of Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium.

³²University of California San Diego School of Medicine, La Jolla, CA, USA.

³³Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

³⁴Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, Advanced Internal Medicine Group, PC, East Hills, NY, USA.

³⁵Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.

³⁶AdventHealth Translational Research Institute, Orlando, FL, USA.

³⁷Imperial College London, London, United Kingdom.

³⁸University of Copenhagen, Copenhagen, Denmark.

³⁹University of Glasgow, Glasgow, United Kingdom.

⁴⁰Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus at the Technische Universität/TU Dresden, Dresden, Germany.

⁴¹Munich Diabetes Research Group e.V. at Helmholtz Centre, Munich, Germany.

⁴²Université Paris-Cité, Institut Universitaire de France, AP-HP, Hôpital Bichat, Cardiology, Paris, France.

⁴³Hacettepe University, Ankara, Turkey.

⁴⁴University of Helsinki, Finnish Institute for Health and Welfare, Helsinki, Finland.

⁴⁵Emory University, Atlanta, GA, USA.

⁴⁶Polyclinique d'Aubervilliers, Aubervilliers and Paris-Nord University, Paris, France.

⁴⁷Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

⁴⁸University of Liverpool, Liverpool, United Kingdom.

⁴⁹Department of Medicine, Duke University Medical Center, Durham, NC, USA.

Abstract

The spectrum of cardiorenal and metabolic diseases comprises many disorders, including obesity, type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), dyslipidemias, hypertension, and associated comorbidities such as pulmonary diseases and metabolism dysfunction-associated steatotic liver disease and metabolism dysfunction-associated steatohepatitis (MASLD and MASH, respectively, formerly known as nonalcoholic fatty liver disease and nonalcoholic steatohepatitis [NAFLD and NASH]). Because cardiorenal and metabolic diseases share pathophysiologic pathways, two or more are often present in the same individual. Findings from recent outcome trials have demonstrated benefits of various treatments across a range of conditions, suggesting a need for practice recommendations that will guide clinicians to better manage complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. To meet this need, we formed an international volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM 2.0 Practice Recommendations, an updated and expanded revision of a previously published multispecialty consensus on the comprehensive management of persons living with DCRM. The recommendations are presented as 22 separate graphics covering the essentials of management to improve general health, control cardiorenal risk factors, and manage cardiorenal and metabolic comorbidities, leading to improved patient outcomes.