Renal Failure

Environmental Drivers of Cardio-Kidney-Metabolic (CKM) Syndrome: Mechanistic Insights, Clinical Translation, and Global Exposures

The formalisation of Cardio-Kidney-Metabolic (CKM) syndrome reflects a transformative shift in clinical medicine that recognises the complex, multi-organ interplay between metabolic risk factors, chronic kidney disease (CKD), and the cardiovascular system. While traditional research has largely focused on unhealthy lifestyle choices, obesity, and genetic predisposition, growing epidemiological and mechanistic evidence highlights environmental exposures as critical, non-traditional drivers of CKM pathogenesis and progression. Ambient air pollution (such as fine particulate matter, PM2.5 and industrial emissions), extreme thermal stress, heavy metal contamination, endocrine-disrupting chemicals, and microplastics act as potent triggers of systemic inflammation, oxidative stress, and endothelial dysfunction. These micro-exposures accelerate microvascular injury in the kidneys, impair myocardial function, and disrupt metabolic homeostasis.

Despite the profound public health burden of environmental drivers, particularly in rapidly industrialising regions and climate-vulnerable communities, the environmental aetiology of CKM syndrome remains under-recognised in routine clinical practice. This Article Collection aims to bridge the gap between environmental epidemiology, basic toxicology, and multi-disciplinary clinical practice. We seek to assemble cutting-edge original research, observational cohort studies, systematic reviews, and translational perspectives that clarify how environmental exposures drive multi-organ injury across the CKM continuum.

We invite submissions addressing, but not limited to, the following themes within the CKM framework:

• Mechanistic Insights: Preclinical and cellular studies detailing how airborne toxins (PM2.5, gas flaring emissions), heavy metals, and microplastics induce systemic inflammation, tubulointerstitial injury, and vascular stiffening.
• Epidemiology & Exposure Assessment: Observational cross-sectional, longitudinal, and spatial-mapping studies linking environmental pollutants and industrial proximity to accelerated eGFR decline, proteinuria, and cardiovascular co-morbidities.
• Thermal Strain & Climate Change: The intersection of rising ambient temperatures, heat-stress nephropathy, occupational dehydration, and metabolic strain.
• Biomarker Discovery: Identification and validation of early, novel biomarkers for subclinical environmental kidney, vascular and endocrine injury.
• Clinical Integration & Public Health: Practical frameworks for embedding environmental exposure history taking into primary care, cardiology, and nephrology intake protocols.
• Health Equity & Policy: Studies evaluating environmental justice, disease burden disparities in low- and middle-income countries (LMICs), and targeted mitigation strategies.

Article Collection key terms:

• Environmental epidemiology
• Cardio-kidney metabolic syndrome
• Cardiovascular disease
• Chronic kidney disease
• Climate Change

Article Collection Guest Advisors:

Prof. Ogochukwu Chinedum Okoye is a Professor of Medicine and the Lead Nephrologist at Delta State University and its Teaching Hospital (DELSUTH) in Nigeria. An expert in kidney disease epidemiology, her research contributions are on the impact of environmental exposures on non-communicable diseases, particularly the emerging global threat of air pollution-associated chronic kidney disease (CKD) and health disparities in vulnerable communities.

She serves as Associate Editor of the Tropical Journal of Nephrology, the official publication of the Nigerian Association of Nephrology, and contributes meaningfully to academic peer review locally and internationally. Professor Okoye was recognised by the American College of Physicians (ACP) as a Global Physician Scholar in 2024 and honoured with Edinburgh Napier University’s 2025 Alumni Excellence Award for her significant contributions to global health. In 2026, she was runner-up in the International Society of Nephrology (ISN) Best Clinical Research Program. She is a dedicated teacher and academic mentor.

Prof. Ejiroghene Martha Umuerri is a Professor of Medicine and Consultant Cardiologist at Delta State University, Nigeria, with expertise in hypertension, preventive cardiology, cardiovascular epidemiology, and women’s cardiovascular health. She has extensive experience in clinical and population-based cardiovascular research, medical education, and translating evidence into practice, particularly in resource-constrained settings. Her research and professional interests span cardiovascular risk-factor management, hypertension, cardiovascular disease prevention, and strengthening research capacity in Africa. She brings a broad clinical, academic, and research perspective to the development and critical appraisal of contemporary cardiovascular literature.

Dr. Oluwatoyin Abisoye Ohenhen is a Consultant Endocrinologist and Senior Lecturer in the Department of Internal Medicine, University of Benin/University of Benin Teaching Hospital, Benin City, Nigeria. A graduate of the University of Benin (MBBS, 2002), she is a Fellow of both the National Postgraduate Medical College of Nigeria and the West African College of Physicians in Endocrinology (2012) and holds a Master of Public Health in Reproductive and Family Health (UNIBEN, 2023), for which she was the best graduating student. Her clinical and research interests centre on diabetes mellitus and general endocrinology—encompassing diabetic peripheral neuropathy and foot syndrome, thyroid and pituitary disorders, metabolic syndrome, and sexual dysfunction in type 2 diabetes—and she has authored numerous peer-reviewed publications while supervising multiple postgraduate research projects and serving as Postgraduate Coordinator in the Department of Medicine, UBTH (2021–2024). She is a member of several professional bodies, including the Endocrine and Metabolism Society of Nigeria, the West African College of Physicians, and the American Association of Clinical Endocrinologists, and remains actively engaged in community health outreach across Edo State.

­­All manuscripts submitted to this Article Collection will undergo a full peer-review; the Guest Advisors for this Collection will not be handling the manuscripts (unless they are an Editorial Board member).

Please review the journal scope and author submission instructions prior to submitting a manuscript.

The deadline for submitting manuscripts is 2nd August 2027.

Please contact Rebecca Kearns at Rebecca.Kearns@tandf.co.uk with any queries and discount codes regarding this Article Collection.

Please be sure to select the appropriate Article Collection from the drop-down menu in the submission system.

The Guest Advisors for this Article Collection have declared no conflict of interests