Issue 11/2025
Karamfilova1, V., Nedeva2, I.
1 Clinic of Endocrinology and Metabolic Diseases, University Hospital „Aleksandrovska“,
Medical University – Sofia
2 Department of Epidemiology and Hygiene, Ministry of Health, Medical University – Sofia
The cardiorenal metabolic syndrome, introduced by the American Heart Association in 2023, represents a complex and interrelated spectrum of diseases driven by shared pathophysiological mechanisms. However, this conceptual framework excludes the liver-an organ central to metabolic regulation. Building upon this paradigm, the cardiorenal-hepatic-metabolic syndrome (CRHMS) incorporates the pivotal role of the liver, particularly through metabolic dysfunction-associated steatotic liver disease (MASLD). Despite the growing prevalence of CRHMS, unified therapeutic strategies remain insufficiently explored. This review discusses how novel antidiabetic agents, including sodium-glucose cotransporter 2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists (GIP/GLP-1RAs), may offer an integrated therapeutic approach to modulate CRHMS beyond traditional specialty boundaries.
Key words: cardiorenal-hepatic-metabolic syndrome, SGLT2i, GLP-1RA, heart failure, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease
Address of correspondence:
Кaramfilova, V.
Clinic of Endocrinology and Metabolic Diseases,
University Hospital „Aleksandrovska“,
Medical University – Sofia
1, „Sv. Georgy Sofiysky“, Blvd.
1431, Sofia