{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:48:14Z","timestamp":1792162094910,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Hypothesis<\/jats:title>\n                    <jats:p>The burden and prognostic significance of inflammation in chronic kidney disease (CKD) remains poorly characterized, with prior studies yielding conflicting estimates of the association between elevated high-sensitivity C-reactive protein (hsCRP) and cardio-kidney outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational nationwide study of 23,008 adults with CKD stages 3\u20135 attending nephrology care and enrolled in the Swedish Renal Registry (2008\u20132023). Inflammation was assessed longitudinally via 94,500 repeated hsCRP registrations. Time-varying, cause-specific Cox models accounting for competing risks estimated associations with study outcomes, which included major adverse cardiovascular events (MACE), heart failure (HF) hospitalization, acute kidney injury (AKI), kidney failure requiring replacement therapy (KFRT) and all-cause mortality. Pre-defined stratifiers were atherosclerotic cardiovascular disease (ASCVD) history and CKD stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 71 years, 65% were male, and median estimated glomerular filtration rate was 25 mL\/min\/1.73 m\u00b2. Median hsCRP was 4.0 (IQR 1.9\u20137.0) mg\/L, and 75% of participants had hsCRP\u22652. Over median 3.9 (IQR 2.0\u20136.7) years, hsCRP \u22652 mg\/L was associated with higher rates of all outcomes: hazard ratio 1.20 (95% confidence interval 1.12\u20131.28) for MACE (n=5,480 events); 1.29 (1.22\u20131.37) for HF hospitalization (n=8,173); 1.28 (1.18\u20131.38) for AKI (n=3,943); 1.09 (1.02\u20131.15) for KFRT (n=6,177); and 1.43 (1.37\u20131.50) for mortality (n=12,645). In spline analyses, associations were steeper at lower hsCRP levels and flatter thereafter for all outcomes except KFRT, where the hsCRP\u2013response relationship was relatively flat. Associations with MACE, HF, AKI and mortality were consistent regardless of ASCVD status and CKD stage. Associations with KFRT were inconsistent across CKD stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this nationwide cohort of adults with moderate to severe CKD receiving nephrology care, inflammation was common, and higher hsCRP levels were associated with adverse cardiovascular and kidney outcomes, as well as mortality. Although associations were less consistent for KFRT, these findings collectively support the utility of hsCRP monitoring in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag240","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:50:24Z","timestamp":1792151424000},"source":"Crossref","is-referenced-by-count":0,"title":["High sensitivity C-reactive protein and the risk of cardio-kidney outcomes in adults with moderate to severe chronic kidney disease: a nationwide study"],"prefix":"10.1093","author":[{"given":"Faizan","family":"Mazhar","sequence":"first","affiliation":[{"name":"Karolinska Institutet Department of Medical Epidemiology and Biostatistics, , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjung","family":"Han","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Department of Medical Epidemiology and Biostatistics, , Stockholm ,","place":["Sweden"]}],"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":"Providence Medical Research Center , Providence Inland Northwest Health, Spokane, WA ,","place":["USA"]},{"name":"Nephrology Division and Kidney Research Institute, University of Washington School of Medicine , Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6019-9342","authenticated-orcid":false,"given":"Aurora","family":"Caldinelli","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Department of Medical Epidemiology and Biostatistics, , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Fugger","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S , S\u00f8borg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Gerward","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S , S\u00f8borg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmi","family":"Mathisen","sequence":"additional","affiliation":[{"name":"Novo Nordisk A\/S , S\u00f8borg ,","place":["Denmark"]}],"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":"The George Institute for Global Health, University of New South Wales , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-5795","authenticated-orcid":false,"given":"Marie","family":"Evans","sequence":"additional","affiliation":[{"name":"Intervention and Technology, Karolinska Institutet Department of Clinical Science, , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4763-2024","authenticated-orcid":false,"given":"Juan-Jesus","family":"Carrero","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Department of Medical Epidemiology and Biostatistics, , Stockholm ,","place":["Sweden"]},{"name":"Division of Nephrology, Department of Clinical Sciences, Danderyd Hospital , Danderyd ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,16]]},"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag240\/72045337\/gfag240.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag240\/72045337\/gfag240.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:15:38Z","timestamp":1792160138000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article\/doi\/10.1093\/ndt\/gfag240\/8931565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfag240","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"article-number":"gfag240"}}