Cardiovascular disease (CVD) and chronic kidney disease (CKD), along with diabetes mellitus (DM), are all major global chronic non-communicable diseases. These three conditions are interconnected and often coexist, forming what is known as cardiorenal metabolic (CRM) syndrome, which has become a serious health issue in modern society.

Using diabetes as an entry point, this study explores the impact of CKM syndrome as a common disease mechanism on hospitalization resource utilization.

A cross-sectional study was conducted using front-page medical record data from patients hospitalized with a principal diagnosis of diabetes mellitus (DM) at a tertiary general hospital in L City between 2020 and 2024. According to the presence of CVD and CKD, patients were classified into four groups: DM without chronic complications, DM with CVD, DM with CKD, and CKM syndrome. Age, length of hospital stay, number of hospitalizations, and hospitalization costs (total inpatient costs, medical service fees, examination and testing fees, medication costs, consumable costs) were compared among the groups. Categorical data were compared using the chi-square test. Non-normally distributed continuous variables were expressed as M (P₂₅, P₇₅) and compared using the Kruskal-Wallis H test; pairwise comparisons were adjusted using the Bonferroni method.

A total of 8 765 patients with DM were included, comprising 3 289 patients with CKM syndrome (37.5%), 3 049 with DM and CVD (34.8%), and 1 616 with DM and CKD (18.4%). Significant differences were observed among the four groups in sex, age, length of hospital stay, number of hospitalizations, total hospitalization costs, medical service costs, examination and laboratory costs, medication costs, and medical consumable costs (all P<0.05). The proportion of patients with CKM syndrome exceeded 40% in all age groups aged 40 and above; the percentage of CKM syndrome patients hospitalized more than 3 times was higher than that of DM patients without chronic complications and DM patients with CVD (P<0.008 3). The median total hospitalization cost for CKM syndrome patients was 6 105.27 (4 674.75, 7 803.20) yuan, which was higher than that for patients with DM without chronic complications and patients with DM and CKD (all P<0.008 3).

Patients with CKM syndrome account for a high proportion of hospitalized DM patients, with a higher prevalence among those aged 40 and above, and they experience a significant economic burden during hospitalization. Early screening, tiered diagnosis and treatment, and comprehensive management should be strengthened to reduce healthcare burden and improve prognosis.