Related Experiment Video

Updated: Apr 25, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

15.4K

Systemic Inflammation and Adverse Outcomes in Patients With Atherosclerotic Cardiovascular Disease and Chronic Kidney

Alexander T Sandhu1, Adam Furst2, Fatima Rodriguez3

  • 1Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA.

JACC. Advances
|April 23, 2026
PubMed

Insights

Systemic inflammation (SI) in Veterans with cardiovascular disease and kidney disease significantly increases the risk of major adverse cardiovascular events (MACE), hospitalizations, and healthcare costs.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Health Economics

Background:

  • Systemic inflammation (SI), indicated by high-sensitivity C-reactive protein (hsCRP), is prevalent in patients with atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD).
  • Understanding the impact of SI on cardiovascular and economic outcomes in this dual-diagnosis population is crucial for clinical management and resource allocation.

Purpose of the Study:

  • To investigate the association between systemic inflammation (SI) and cardiovascular events, acute care utilization, and healthcare costs among Veterans diagnosed with both ASCVD and CKD.
  • To quantify the increased risk of major adverse cardiovascular events (MACE) and economic burden attributable to SI in this cohort.

Main Methods:

  • Analysis of Veterans with ASCVD and CKD undergoing hsCRP testing between 2008 and 2022.
  • Classification of patients into SI (hsCRP 2-10 mg/L) and non-SI (hsCRP <2 mg/L) groups.
  • Utilized Cox regression, negative binomial regression, and gamma regression to assess associations with MACE, hospitalizations, and costs, respectively.

Main Results:

  • Veterans with SI were younger and had a higher prevalence of peripheral arterial disease.
  • A significantly higher rate of MACE (11.64 vs 8.66 per 100 patient-years) was observed in the SI group.
  • SI was independently associated with a 40% increased risk of MACE (HR: 1.40), increased hospitalizations (IRR: 1.24), and an additional $4,115 in annual healthcare costs.

Conclusions:

  • Systemic inflammation is a significant independent predictor of adverse cardiovascular outcomes in Veterans with ASCVD and CKD.
  • SI contributes to increased healthcare utilization and substantial economic costs in this patient population.
  • Targeting systemic inflammation may be a key strategy to improve outcomes and reduce costs for Veterans with comorbid ASCVD and CKD.
Abstract

Keywords:
chronic renal insufficiencycoronary artery diseaseepidemiologyhealth resourcesinflammation

More Related Videos

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy07:52

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy

Published on: November 7, 2017

20.5K
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis08:21

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

4.9K

Related Concept Videos

Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
1.1K
Acute Inflammation II: Local and Systemic Effects01:25

Acute Inflammation II: Local and Systemic Effects

Acute inflammation produces a coordinated set of local and systemic changes that limit injury, eliminate pathogens, and initiate repair. These responses arise within minutes of infection, trauma, or chemical insult and are driven by vascular alterations and leukocyte-derived mediators. When the stimulus resolves, the reaction typically abates within days.Local EffectsAt the site of injury, arteriolar vasodilation increases blood flow, resulting in redness and warmth. Simultaneously, increased...
45
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
1.3K
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
2.2K
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
676
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
1.7K