Department of Community Medicine, West Virginia University School of Medicine, Morgantown, West Virginia 26506, USA.
Kidney Int. 2011 Dec;80(11):1231-8. doi: 10.1038/ki.2011.283. Epub 2011 Aug 24.
In animal models, inflammatory processes have been shown to have an important role in the development of kidney disease. In humans, however, the independent relation between markers of inflammation and the risk of chronic kidney disease (CKD) is not known. To clarify this, we examined the relationship of several inflammatory biomarker levels (high-sensitivity C-reactive protein, tumor necrosis factor-α receptor 2, white blood cell count, and interleukin-6) with the risk of developing CKD in a population-based cohort of up to 4926 patients with 15 years of follow-up. In cross-sectional analyses, we found that all these inflammation markers were positively associated with the outcome of interest, prevalent CKD. However, in longitudinal analyses examining the risk of developing incident CKD among those who were CKD-free at baseline, only tumor necrosis factor-α receptor 2, white blood cell count, and interleukin-6 levels (hazard ratios comparing highest with the lowest tertile of 2.10, 1.90, and 1.45, respectively), and not C-reactive protein (hazard ratio 1.09), were positively associated with incident CKD. Thus, elevations of most markers of inflammation predict the risk of developing CKD. Each marker should be independently verified.
在动物模型中，炎症过程被证明在肾脏疾病的发展中起着重要作用。然而，在人类中，炎症标志物与慢性肾脏病（CKD）风险之间的独立关系尚不清楚。为了阐明这一点，我们在一个基于人群的队列中，对多达 4926 名患者进行了 15 年的随访，检查了几种炎症生物标志物水平（高敏 C 反应蛋白、肿瘤坏死因子-α受体 2、白细胞计数和白细胞介素-6）与 CKD 发病风险之间的关系。在横断面分析中，我们发现所有这些炎症标志物与我们感兴趣的结局（CKD 前期）均呈正相关。然而，在对基线时无 CKD 的患者进行的分析中，只有肿瘤坏死因子-α受体 2、白细胞计数和白细胞介素-6 水平（最高三分位与最低三分位相比的风险比分别为 2.10、1.90 和 1.45），而不是 C 反应蛋白（风险比 1.09），与新发 CKD 呈正相关。因此，大多数炎症标志物的升高都预示着 CKD 发病的风险。每个标志物都应独立验证。
