Chronic kidney disease (CKD) is a highly prevalent condition worldwide and is associated with a substantial cardiovascular burden and premature mortality [1,2]. The risk of cardiovascular events and death increases progressively with declining estimated glomerular filtration rate (eGFR) and rising albuminuria, usually quantified as the urine albumin-to-creatinine ratio (UACR). Although these two markers remain central to kidney and cardiovascular risk stratification [3], they do not fully capture the complex pathophysiological mechanisms underlying the excess risk observed in CKD, prompting interest in additional biomarkers that may better reflect the broader cardio-kidney-metabolic disturbance.
