Inflammation and Cardiovascular Risk in Chronic Kidney Disease

Chronic kidney disease (CKD) is underpinned by a persistent, low-grade inflammatory state that accelerates both renal deterioration and cardiovascular complications. Disruption of the balance between pro- and anti-inflammatory mediators arises from heightened innate immune activation, oxidative stress, alterations in adipose tissue metabolism and dysbiosis of the gut microbiota. This milieu promotes endothelial dysfunction, vascular calcification and accelerated atherosclerosis, factors central to the markedly elevated risk of myocardial infarction, stroke and heart failure in CKD populations. Traditional risk factors, including hypertension, diabetes and dyslipidaemia, are amplified by inflammatory processes, while reliance on dialysis introduces further bidirectional inflammatory stimuli. Clinically, biomarkers of inflammation—ranging from acute-phase proteins to composite indices—have emerged as prognostic tools for both renal and cardiovascular outcomes. Advances in metabolic profiling and immunomodulatory therapies offer pathways to more personalised management. Emphasis on early detection of inflammatory activation and integration of anti-inflammatory strategies into CKD care may reduce cardiovascular morbidity and improve long-term survival.

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Inflammation and Cardiovascular Risk in Chronic Kidney Disease publication trend

The graph below shows the total number of articles in inflammation and cardiovascular risk in chronic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Chronic kidney disease (CKD): progressive loss of kidney function over months or years, often defined by reduced glomerular filtration rate or evidence of kidney damage.

Systemic Inflammatory Response Index (SIRI): a composite marker calculated from neutrophil, monocyte and lymphocyte counts to quantify systemic inflammation.

Neutrophil-to-lymphocyte ratio (NLR): the ratio of circulating neutrophil count to lymphocyte count, reflecting the balance between innate and adaptive immune responses.

Glomerular filtration rate (GFR): the volume of fluid filtered by the kidneys per minute, serving as the primary measure of renal function.

C-reactive protein (CRP): an acute-phase protein synthesized by the liver in response to inflammatory cytokines, used as a general marker of inflammation.

Cytokines: signalling proteins such as interleukin-6 or tumour necrosis factor-alpha that orchestrate immune and inflammatory processes.

References

1. Systemic Inflammatory Response Index (SIRI) is associated with all-cause mortality and cardiovascular mortality in population with chronic kidney disease: evidence from NHANES (2001–2018). Frontiers in Immunology (2024).
2. The Role of Inflammation in CKD. Cells (2023).
3. Metabolic Pathways Affected in Patients Undergoing Hemodialysis and Their Relationship with Inflammation. International Journal of Molecular Sciences (2024).