{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:46:55Z","timestamp":1792169215717,"version":"4.4.0"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiorenal Med"],"abstract":"<jats:p>Background: Patients with chronic kidney disease (CKD) have a &gt;10-fold higher risk of cardiovascular mortality than the general population, influenced by both traditional and non-traditional risk factors. Residual cardiovascular risk persists despite effective lipid lowering and antihypertensive treatment, suggesting that inflammation-driven mechanisms have been neglected. High-sensitivity C-reactive protein (hs-CRP) as a sensitive marker of systemic low-grade inflammation is a recognized risk-enhancing biomarker in atherosclerotic cardiovascular disease (ASCVD), but its precise role, optimal thresholds, and therapeutic relevance in concomitant CKD-ASCVD remain poorly synthesized. Summary: PubMed\/MEDLINE, Scopus and EMBASE (January 1989\u2013March 2026) were searched to consolidate evidence on hs-CRP in CKD-ASCVD from mechanistic, epidemiological, and clinical trials. Data supports a bidirectional cardiorenal axis: progressive CKD elevates hs-CRP by uremic toxin-induced interleukin-6 (IL-6), nuclear factor kappa-B (NF-\u03baB) activation, atherosclerosis, while high hs-CRP aggravates renal deterioration by CD32b-Smad3-transforming growth factor beta 1 (TGF-\u03b21) related tubulointerstistial fibrosis. hs-CRP &gt;3 mg\/L nearly doubles heart failure risk in CKD. Cumulative exposure increases the risk of developing CKD by 70% (hazard ratio [HR] 1.70) and cardiovascular mortality by up to three-fold. CKD-specific recalibration needed for standard thresholds (&lt;1, 1\u20133, &gt;3 mg\/L). Novel anti-inflammatory agents, colchicine and ziltivekimab, reduce hs-CRP by 77\u201392% and lower cardiovascular events in general ASCVD populations, but advanced CKD evidence remains limited with outcome trials ongoing. Key Messages: hs-CRP is a marker of a pathogenic bidirectional cardiorenal loop, independently associated with cardiovascular events, CKD progression, and death, beyond LDL-cholesterol and traditional risk factors. Serial hs-CRP monitoring as a continuous measure may be superior to threshold-based categorization, pending CKD-specific validation. IL-1\u03b2\/IL-6 pathway inhibitors and colchicine are promising for residual inflammatory risk but hs-CRP itself is not validated as a direct therapeutic target.<\/jats:p>","DOI":"10.1159\/crm\/abtag019","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:52:32Z","timestamp":1792065152000},"source":"Crossref","is-referenced-by-count":0,"title":["High-sensitivity C-Reactive Protein as a Risk-Enhancing Biomarker in Patients with Chronic Kidney Disease and Atherosclerotic Cardiovascular Disease: A Narrative Review"],"prefix":"10.1159","author":[{"given":"Ganesha","family":"Prakash N S","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Devasia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Paramasivam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indu Ramachandra","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navaneeth","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"N Shetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,15]]},"container-title":["Cardiorenal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/crm\/abtag019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:01:17Z","timestamp":1792166477000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/crm\/abtag019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/crm\/abtag019","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.34487364","asserted-by":"subject"}]},"ISSN":["1664-3828","1664-5502"],"issn-type":[{"value":"1664-3828","type":"print"},{"value":"1664-5502","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]}}}