Inflammatory Markers May Predict CKD Risk

Elevated levels of several markers of inflammation predict an increased long-term risk of chronic kidney disease (CKD), reports a study in the American Journal of Kidney Diseases.

The researchers analyzed data from a predominantly white population of patients enrolled in a prospective study of CKD risk factors. Up to 4926 participants were followed up for 15 years. Levels of inflammatory markers—high-sensitivity C-reactive protein, tumor necrosis factor-α receptor 2 (TNF-αR2), white blood cell count, and interleukin-6—were measured in stored blood samples. Associations with CKD were examined in cross-sectional and longitudinal analyses.

All four inflammatory markers were associated with a higher prevalence of CKD at baseline. On longitudinal analysis of participants free of CKD at baseline, all markers except for C-reactive protein were associated with incident CKD. Hazard ratios, comparing the highest with the lowest tertiles of biomarker levels, were 2.10 for TNF-αR2, 1.90 for white blood cell count, and 1.45 for interleukin-6. The associations were “relatively robust” on adjustment for confounders, and remained significant on analyses using different definitions of CKD.

Animal experiments suggest that inflammatory processes play an important role in the development of kidney disease. The new study identifies several inflammatory biomarkers associated with prevalent and incident CKD in a general population sample. If the findings are borne out by future studies, measuring TNF-αR2, white blood cells, and interleukin-6 might provide a new approach to identifying patients at high risk of CKD [Shankar A, et al: Markers of inflammation predict the long-term risk of developing chronic kidney disease: a population-based cohort study. Kidney Int 2011; 80:1231–1238].