Abstract Introduction: Cardiovascular-kidney-metabolic syndrome (CKM) is a systemicdisorder linked to insulin resistance. The association between estimated plasmavolume status (ePVS) and progression from CKM stage 2 (CKM2) to stage 4(CKM4) remains poorly understood. This study assessed the association betweenePVS and CKM2-to-CKM4 progression. Methods: A total of 36,505 hospitalized CKM2 patients from the TJHFIT cohortwere followed for 10 years, with 15,495 incident CKM4 events.
