The group of cardio-renal-metabolic diseases, encompassing chronic kidney disease, obesity, type 2 diabetes mellitus, atherosclerotic cardiovascular diseases, and heart failure, represents a significant global health challenge, contributing substantially to the increasing burden of morbidity and cardiovascular mortality. In recent years, considerable attention has been directed toward the relationship between the intestinal microbiota and the host organism, as studies have revealed the essential metabolic role of the intestinal microbiome and its impact on immune dysregulation within the gastrointestinal tract. The intestinal microbiome functions as an endocrine organ, producing bioactive metabolites such as short chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO), and bile acids, which directly and indirectly influence inflammation, metabolic function, and intestinal barrier integrity. Furthermore, the microbiome modulates immunological and hormonal mechanisms of the host, mediating bidirectional communication between the gut and key organs, including the heart, kidneys, and metabolic systems.