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Updated: Jun 9, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Associations between inflammatory markers and carotid plaques in CKD: mediating effects of eGFR-a cross-sectional
Li Wang1,2,3, Jialin Wang1,2,3, Jun Ji1,2,3
1Department of Nephrology, Zhongshan Hospital, Fudan University, No 180 Fenglin Rd., Shanghai, China.
Insights
Inflammatory markers like SIRI and MHR are linked to carotid plaques in chronic kidney disease (CKD) patients. Estimated glomerular filtration rate (eGFR) partially mediates this association, emphasizing inflammation control for cardiovascular health.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Immunology
Background:
- Chronic kidney disease (CKD) is a major health issue.
- CKD patients have a high prevalence of carotid plaques, indicating atherosclerosis.
- Inflammation is central to CKD, driving both kidney dysfunction and cardiovascular disease.
Purpose of the Study:
- To investigate the association between various inflammatory markers and carotid plaques in CKD patients.
- To explore the potential mediating role of estimated glomerular filtration rate (eGFR) in this relationship.
Main Methods:
- Cross-sectional analysis of 387 CKD patients.
- Carotid plaques assessed via ultrasound.
- Multivariable logistic regression, trend tests, restricted cubic spline (RCS), and subgroup analyses were employed.
- Mediation analysis examined the role of eGFR.
Main Results:
- Elevated levels of LnSIRI, LnSII, LnAISI, LnMHR, LnNHR, and LnMLR were significantly associated with carotid plaques.
- Significant trends observed for increasing tertiles of SIRI, AISI, MHR, and NHR.
- eGFR partially mediated these associations, accounting for 14.7% to 17.5%.
Conclusions:
- Inflammatory markers are strongly associated with carotid plaques in CKD.
- eGFR plays a partial mediating role in the link between inflammation and carotid plaques.
- Managing inflammation and preserving renal function are crucial for reducing atherosclerosis risk in CKD.
Background:
Chronic kidney disease (CKD) is a significant public health concern associated with a high prevalence of carotid plaques, which are indicators of atherosclerosis and predictors of adverse cardiovascular outcomes. Inflammation is a hallmark of CKD, contributing to both renal dysfunction and cardiovascular complications. This study aims to investigate the association between inflammatory markers-systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), aggregate inflammatory status index (AISI), monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR)-and carotid plaques in CKD patients, and to explore the potential mediating role of estimated glomerular filtration rate (eGFR) in this relationship.
Methods:
A cross-sectional analysis was conducted on patients admitted to the Division of Nephrology between January 2023 and June 2023. The primary endpoint was the presence of carotid plaques assessed using ultrasound imaging. Multivariable logistic regression models were used to examine the associations between inflammatory markers and carotid plaques, and trend tests were performed to evaluate the trending association of carotid plaques risk and inflammatory markers in tertiles. Restricted cubic spline (RCS) analysis was used to assess potential non-linear relationships, and subgroup analyses were conducted to examine consistency across different strata. Mediation analysis was performed to explore the role of eGFR.
Results:
Of the 609 participants, 387 were included in the final analysis after applying exclusion criteria. Elevated levels of LnSIRI (OR = 1.87, 95% CI = 1.25-2.80), LnSII (OR = 1.67, 95% CI = 1.09-2.56), LnAISI (OR = 1.70, 95% CI = 1.22-2.37), LnMHR (OR = 1.94, 95% CI = 1.15-3.26), LnNHR (OR = 1.82, 95% CI = 1.10-3.02), and LnMLR (OR = 2.26, 95% CI = 1.18-4.34) were significantly associated with the presence of carotid plaques. There were significant trends for increasing tertiles of SIRI, AISI, MHR and NHR. RCS analysis showed no significant non-linear associations. Subgroup analyses indicated similar associations across most strata. eGFR partially mediated these relationships, with proportions mediated ranging from 14.7 to 17.5%.
Conclusions:
Inflammatory markers are significantly associated with carotid plaques in CKD patients, with eGFR playing a partial mediating role. These findings highlighted the importance of managing inflammation and maintaining renal function to mitigate the risk of atherosclerosis in CKD patients.
Trial Registration:
Not applicable.
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