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We aimed to evaluate the associations between baseline inflammatory markers [interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)] and long-term renal function decline and incident chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This prospective cohort study included participants of the Multi-Ethnic Study of Atherosclerosis (MESA) with estimated glomerular function (eGFR) &amp;gt; 60 mL\/min\/1.73 m2 and available IL-6 and hsCRP measurements at visit 1. Outcomes included longitudinal changes in eGFR and log-transformed urinary albumin\u2013creatinine ratio [log(UACR)] through visit 5, and incident CKD through 2018. Mixed-effect linear regression models assessed renal function decline. Fine-Gray regression was used to model incident CKD, accounting for competing mortality. Among 4680 (hsCRP) and 4580 (IL-6) participants (median follow-up for incident CKD: 16.8 years), higher IL-6 was consistently associated with faster eGFR decline [tertile 3 (T3; vs. T1): \u22120.32 mL\/min\/1.73m2\/year (95% CI: 0.23\u20130.42 mL\/min\/1.73m2\/year), P &amp;lt; 0.001] greater log[UACR] increase [T3: 6.67 \u00d7 10\u22123 unit\/year (2.95 \u00d7 10\u20133\u201310.39 \u00d7 10\u22123 unit\/year), P &amp;lt; 0.001], and higher CKD incidence [T3: sub-hazard ratio 1.65 (1.23\u20132.20), P = 0.001]. Contrastingly, hsCRP exhibited weaker and inconsistent associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated IL-6 predicts greater long-term eGFR decline, worsening albuminuria, and higher CKD risk. These results highlight IL-6\u2019s potential as a renal risk biomarker, meriting further study in cardiovascular\u2013kidney\u2013metabolic (CKM) syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>This study investigated how inflammation is related to deteriorations in kidney function and the occurrence of chronic (long-term) kidney disease (CKD), both of which are critical components of the cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome. Using data from the Multi-Ethnic Study of Atherosclerosis, over 4500 volunteers had inflammation markers measured and were followed for almost 17 years. We found that higher levels of inflammation were correlated with worse deterioration in kidney function and higher risks of developing CKD. These findings reaffirmed the pivotal role of inflammation in the long-term development of kidney disease. This study highlights the need for further investigation of how inflammatory markers can be used to predict future heart and kidney disease, especially as new drugs to treat inflammation are being developed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf779","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:58:50Z","timestamp":1766149130000},"page":"718-728","source":"Crossref","is-referenced-by-count":7,"title":["The role of inflammation in longitudinal renal function decline and incident chronic kidney disease: the multi-ethnic study of atherosclerosis"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1793-4734","authenticated-orcid":false,"given":"Olayinka J","family":"Agboola","sequence":"first","affiliation":[{"name":"Inova Schar Heart and Vascular, Inova Health System , Falls Church, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S K","family":"Chan","sequence":"additional","affiliation":[{"name":"Cardiovascular Analytics Group, China-UK Collaboration , Hong Kong ,","place":["China"]},{"name":"Norwich Medical School, University of East Anglia , Norwich NR4 7TJ ,","place":["United Kingdom"]},{"name":"School of Nursing and Health Studies, Hong Kong Metropolitan University , Kowloon, Hong Kong ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared A","family":"Spitz","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular, Inova Health System , Falls Church, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond N C","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital , New Territories, Hong Kong ,","place":["China"]},{"name":"School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong , Hong Kong ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaideep","family":"Patel","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine , Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"German","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Medstar Georgetown University Hospital , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khurram","family":"Nasir","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Houston Methodist , Houston, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Blaha","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong , Hong Kong ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Mehta","sequence":"additional","affiliation":[{"name":"VCU Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima V","family":"Sharma","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular, Inova Health System , Falls Church, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9071-3287","authenticated-orcid":false,"given":"Michael D","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Center for Prevention of Cardiovascular Disease, Department of Cardiology, Wake Forest University School of Medicine , Bowman Gray Center for Medical Education, 475 Vine Street, Winston-Salem, NC 27101 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