{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:17:24Z","timestamp":1787008644242,"version":"build-2736575974"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008349","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008349","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eli Lilly"},{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) is characterized by chronic inflammation, which is strongly linked to risk of cardiovascular disease. Anti-inflammatory agents present a novel strategy to reduce the burden of cardiovascular disease in people with CKD, but their effects on clinical outcomes are uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis was performed to assess the efficacy and safety of anti-inflammatory agents in CKD (PROSPERO CRD42021238755). Medline, Embase and Cochrane databases were searched up to 8 October 2024 for randomized controlled trials of anti-inflammatory agents in CKD with at least 100 patient-years follow-up per treatment arm. The primary study outcome was major adverse cardiovascular events (MACE; defined as myocardial infarction, stroke or cardiovascular death). Other outcomes included CKD progression, malignancy and infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine trials of 12\u2009042 participants and six different anti-inflammatory classes were identified. Overall, anti-inflammatory agents did not reduce the risk of MACE [risk ratio (RR) 1.01, 95% confidence interval (CI) 0.81\u20131.24], although there was significant heterogeneity across studies (P-heterogeneity\u00a0=\u00a0.001; I2\u00a0=\u00a072%). Anti-inflammatory agents did not have a clear effect on the composite kidney outcome (RR 0.82, 95% CI 0.55\u20131.22), although there were few events and some trials suggested improvements in the rate of decline in kidney function. Infections were increased with anti-inflammatory agents compared with placebo (RR 1.35, 95% CI 1.01\u20131.82).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is currently insufficient evidence to support the use of anti-inflammatory agents to reduce cardiovascular risk or CKD progression in people with CKD, and further dedicated studies in this population are warranted. The potential increased risk of infection with anti-inflammatory agents is an important consideration in the evaluation of these therapies in CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf001","type":"journal-article","created":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T23:14:55Z","timestamp":1736723695000},"source":"Crossref","is-referenced-by-count":6,"title":["Effects of anti-inflammatory agents on clinical outcomes in people with chronic kidney disease: a systematic review and meta-analysis of randomized control trials"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9255-6031","authenticated-orcid":false,"given":"Emma R","family":"Webster","sequence":"first","affiliation":[{"name":"The Children's Hospital at Westmead , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Perkovic","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Newcastle , Newcastle, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-8380","authenticated-orcid":false,"given":"Brendon L","family":"Neuen","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Royal North Shore Hospital , Sydney, NSW ,","place":["Australia"]},{"name":"The George Institute for Global Health, University of New South Wales , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2235-0103","authenticated-orcid":false,"given":"Katherine R","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Nephrology Division, University of Washington School of Medicine , Seattle, WA ,","place":["USA"]},{"name":"Providence Inland Northwest Health , Spokane, WA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlado","family":"Perkovic","sequence":"additional","affiliation":[{"name":"University of New South Wales , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"2025040309400275600_bib1","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"Lancet North Am Ed"},{"key":"2025040309400275600_bib2","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1681\/ASN.2004080656","article-title":"Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study","volume":"16","author":"Muntner","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"2025040309400275600_bib3","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.4065\/80.10.1270","article-title":"Cardiovascular risk factor profiles and kidney function stage in the US general population: the NHANES III study","volume":"80","author":"Foley","year":"2005","journal-title":"Mayo Clin Proc"},{"key":"2025040309400275600_bib4","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume-title":"Lancet North Am Ed","year":"2010"},{"key":"2025040309400275600_bib5","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1038\/ki.2010.536","article-title":"Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. 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