To appreciate and define the role of nephrologists in the newly defined cardiovascular-kidney-metabolic (CKM) syndrome, we acknowledge the important shift that must occur from a specialty that has traditionally focused on treating people with organ failure to one that needs to now embrace the concepts of prevention, early diagnosis, and delay of progression as complementary to historical roles as providers of dialysis and transplantation. We describe the value that nephrology can play in further refining the CKM syndrome model to acknowledge the importance of the diagnostic precision of chronic kidney disease and kidney outcomes and question the linearity of the model, given the complexities of chronic kidney disease and cardiovascular disease.