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However, data regarding its impact on long-term renal outcomes is lacking. We classified all asthma patients who were followed at Queen Mary Hospital in 2017 into eosinophilic or non-eosinophilic phenotypes based on their highest blood eosinophil counts (BEC) during stable state in the year (\u2265\u2009300 or\u2009&lt;\u2009300 cells\/mm<jats:sup>3<\/jats:sup> respectively) and prospectively evaluated their clinical outcomes in the subsequent 5\u00a0years. The relationship between patient phenotypes and the long-term renal outcomes were assessed. Five hundred and four asthma patients with baseline Stage 1 to 3 chronic kidney disease were included [296 (58.7%) and 208 (41.3%) in eosinophilic and non-eosinophilic groups respectively]. Among patients with baseline renal function at CKD stage 1 to 3, one hundred and four patients (20.6%) had renal progression in this cohort (56 patients (26.9%) vs. 48 patients (16.2%) in the non-eosinophilic and eosinophilic groups respectively). Patients with non-eosinophilic asthma showed increased risks of renal progression over 5\u00a0years of follow-up [adjusted odds ratio (aOR) 2.615, 95% CI 1.151\u20135.942 p\u2009=\u20090.022] and more rapid eGFR decline (\u22124.29\u2009\u00b1\u20093.48\u00a0mL\/min\/1.73m<jats:sup>2<\/jats:sup>\/year vs. \u22123.48\u2009\u00b1\u20093.07\u00a0mL\/min\/1.73m<jats:sup>2<\/jats:sup>\/year, p\u2009=\u20090.007) than those with eosinophilic phenotype. Patients who developed renal progression had higher risk of death [adjusted hazard ratio (aHR) 1.614 (95% CI 1.041\u20132.502); p\u2009=\u20090.032]. Progressive renal function deterioration is prevalent amongst asthma patients, and those with non-eosinophilic phenotype are at risk of renal progression.<\/jats:p>","DOI":"10.1038\/s41598-025-18035-5","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:54:17Z","timestamp":1761036857000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Immunological phenotype in asthma and its impact on long-term renal outcomes"],"prefix":"10.1038","volume":"15","author":[{"given":"Wang Chung","family":"Kwok","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence Chi Chun","family":"Tam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Chung Man","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Chi Leung","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac Sze Him","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Sau Man","family":"Ip","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desmond Yat Hin","family":"Yap","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"18035_CR1","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1164\/rccm.200906-0896OC","volume":"181","author":"WC Moore","year":"2010","unstructured":"Moore, W. 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