The following is a summary of “Inflammatory Chronic Kidney Disease is Associated With Incident Heart Failure: A Pooled Cohort Analysis,” published in the November 2023 issue of Cardiology by Hamid et al.
While high-sensitivity C-reactive protein (hs-CRP) is a risk marker for cardiovascular disease, including HF, its utility in stratifying heart failure (HF) risk in chronic kidney disease (CKD) patients remains unclear.
Researchers started a retrospective study to investigate whether hsCRP could identify CKD patients at increased risk of developing HF.
They examined participants from three major epidemiologic cohorts: Atherosclerosis Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Jackson Heart Study. High inflammation was defined as hsCRP >3 mg/L, and CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73m2. Participants fell into three groups, healthy, CKD without high inflammation, and CKD with high inflammation. Cox models were analyzed, adjusting for age, gender, race, BMI, smoking, alcohol use, diabetes, hypertension, and coronary disease.
The results showed 8,692 participants with 460 incident HF events with a median period of 8.32 years. Individuals with CKD but without high inflammation (HR = 1.45; 95% CI 1.14 to 1.85) and those with CKD and high inflammation (HR = 2.05; 95% CI 1.61 to 2.61) exhibited an elevated risk of incident HF compared to those without CKD or high inflammation. Participants with CKD and hsCRP >3 mg/L had an increased risk of incident HF (HR = 1.41; 95% CI 1.06 to 1.88) in comparison to those with CKD but hsCRP ≤3 mg/L.
They concluded that high inflammation in CKD patients doubled their heart failure risk, suggesting hsCRP >3mg/L as a potential risk-stratification tool.