Kidney Week

Abstract: FR-PO346

Serum C-reactive Protein and Risk of Major Kidney Outcomes in Adults with Atherosclerotic Cardiovascular Disease Managed in Routine Care

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Tuttle, Katherine R., School of Medicine, University of Washington and Providence Inland Northwest Health, Spokane, Washington, United States

Katherine R. Tuttle, MD, FASN

• Mazhar, Faizan, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Faizan Mazhar, PharmD, PhD

• Fu, Edouard, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Edouard Fu, PhD

• Faucon, Anne-Laure, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Anne-Laure Faucon, MD, PhD

• Hjemdahl, Paul, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Paul Hjemdahl, MD, PhD

• Mathisen, Jimmi, Novo Nordisk A/S, Søborg, Denmark

Jimmi Mathisen, MSc, PhD

• Muhammad, Iram Faqir, Novo Nordisk A/S, Søborg, Denmark

Iram Faqir Muhammad, MBBS, PhD, MPH

• Plunde, Oscar, Novo Nordisk A/S, Søborg, Denmark

Oscar Plunde, MD, PhD

• Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic, MBBS, PhD, FASN

• Carrero, Juan Jesus, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Juan Jesus Carrero, PharmD, PhD

Background

Inflammasome pathway activation is involved in atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD), but it is unclear if systemic inflammation, measured by serum C-reactive protein (CRP), predicts major kidney outcomes in patients with ASCVD.

Methods

This was an observational study of adults with ASCVD undergoing routine CRP testing in Stockholm, Sweden. Baseline CRP was defined as the mean of serum CRP test levels over a 3-month window, excluding tests associated with illness or medications. Baseline CRP was analyzed via cause-specific Cox regression for subsequent risk of acute kidney injury (AKI; diagnosis code or KDIGO criteria) or CKD progression (>30% eGFR decline or kidney failure).

Results

A total of 83,928 adults with ASCVD were included (54% men, mean age 71 years, 59% with CRP ≥2 mg/L). A progressive increase in CRP levels was observed across lower eGFR categories. Over median follow-up of 6.4 years (IQR 3.1–9.8), 8371 CKD progression events, 10,757 AKI events, and 24,954 deaths were recorded. Compared with CRP <1 mg/L, higher CRP levels were associated with increased risks of CKD progression and AKI (Figure). Associations were consistent across subgroups defined by age, albuminuria, selected comorbidities, and use of lipid-lowering therapy. Results were robust when excluding extreme CRP values or early events, and did not appear to be explained by differences in eGFR testing rates.

Conclusion

In a population of adults with ASCVD, systemic inflammation was associated with higher risk of major kidney outcomes.

Funding

• Commercial Support – This study was funded by Novo Nordisk A/S.