- Elevated levels of high-sensitivity C-reactive protein (hsCRP) are associated with subsequent risk for acute kidney injury (AKI) and progression of chronic kidney disease (CKD) in patients after myocardial infarction (MI).
Why this matters
- Findings support the hypothesis that inflammation may be one of the pathways connecting cardiac and kidney dysfunction, and this association may help in implementing preventive therapies and lifestyle changes.
- 12,905 MI survivors who underwent hsCRP testing >30 days with available information on estimated glomerular filtration rate (eGFR) were included.
- Main outcomes included CKD progression (composite of doubling plasma creatinine, renal replacement therapy or renal death) and AKI (plasma creatinine level >26.5 μmol/L according to the Kidney Disease: Improving Global Outcomes criteria).
- Funding: None disclosed.
- During a median follow-up of 3.2 years, 1019 CKD progressions (incident rate, 2.7%) and 1481 AKI events (incident rate, 3.95%) were reported.
- After adjustment for confounders, patients with hsCRP ≥2 mg/L vs those with hsCRP
- Compared to those with hsCRP ≤1 mg/L, HRs for patients with 1-3, 3-10 and >10 mg/L, respectively, were:
- CKD progression
- 1.26 (95% CI, 1.03-1.53),
- 1.55 (95% CI, 1.29-1.86) and
- 1.62 (95% CI, 1.31-2.01).
- 1.22 (95% CI, 1.04-1.43),
- 1.43 (95% CI, 1.22-1.66) and
- 1.51 (95% CI, 1.27-1.81).
- The association between hsCRP and AKI was weakened in a sub-analysis of patients with eGFR 30-44 mL/min/1.73 m2 and eGFR ≤30 mL/min/1.73 m2.
- Results have limited generalisability.
- Potential risk for residual and unknown confounding