Inflammatory Marker Mania in Chronic Kidney Disease

Even though the high prevalence of chronic inflammation and its link to poor outcome in chronic kidney disease (CKD) are not news any more (1,2), many clinicians and investigators remain interested in research about inflammatory markers in kidney disease. There are several reasons: ( a ) Recent studies, both epidemiologic and basic science, have suggested that in the general population, chronic inflammation may have a stronger causal role in engendering atherosclerotic cardiovascular disease than LDL hypercholesterolemia (3,4); this notion may lead to a major shift away from the traditional Framingham paradigm and toward the nontraditional paradigm of inflammation (5); ( b ) inflammation seems to be at least one of the reasons for the high burden of atherosclerotic cardiovascular disease and death in individuals with CKD (6); ( c ) patients with CKD and higher serum levels of inflammatory markers such as C-reactive protein (CRP) and IL-6 have a higher rate of CKD progression (7) and poor clinical outcomes, including higher death rates (8); and ( d ) inflammation may be the missing link between the surrogates of malnutrition-wasting syndrome such as hypoalbuminemia and poor survival in patients with CKD, especially. those who undergo maintenance dialysis treatment (9,10). On the basis of these premises, many nephrologists are interested in relevant information about the inflammatory markers and their associations with both CKD progression and cardiovascular disease and death in this population (Table 1).View this table: Table 1. Inflammatory markers that have been studied in patients with CKDaCRP is probably the most notorious inflammatory marker in CKD. It was first described in the 1930s for its role in serologic reactions to pneumococcal pneumonia …