Predictive Effect of System Inflammation Response Index for Progression of Chronic Kidney Disease in Non-Dialyzing Patient

Figures & data

Figure 1 Inclusion process.

Table 1 Baseline Characteristics of Quantiles of Ln(SIRI) Among the Non-Dialysis CKD Adult Population

	Ln(SIRI)				P
	Q1	Q2	Q3	Q4
	≤-0.39	−0.39~0.037	0.037~0.5	>0.5
Age (year)	58.1±16.88	60.4±17.3	62.38±16.31	65.99±15.83	<0.001
Male	203(57.3%)	213(60.2%)	220(62%)	257(72.6%)	<0.001
BMI (kg/m^2)	23.52±3.53	23.43±3.67	23.33±3.47	22.8±3.96	0.041
Smoker	56(15.8%)	52(14.7%)	68(19.2%)	84(23.7%)	0.009
Drinker	35(9.9%)	27(7.6%)	42(11.8%)	40(11.3%)	0.25
Hypertension	206(58.2%)	245(69.2%)	245(69%)	270(76.3%)	<0.001
CAD	54(15.3%)	56(15.8%)	90(25.4%)	95(26.8%)	<0.001
DM	159(44.9%)	169(47.7%)	167(47%)	150(42.4%)	0.475
Stroke	41(11.6%)	40(11.3%)	47(13.2%)	63(17.8%)	0.042
Heart failure	47(13.3%)	69(19.5%)	81(22.8%)	97(27.4%)	<0.001
Atrial fibrillation	11(3.1%)	13(3.7%)	22(6.2%)	21(5.9%)	0.123
Progression of CKD	40(11.3%)	58(16.4%)	59(16.6%)	87(24.6%)	<0.001
Antihypertensive agents	264(74.6%)	302(85.3%)	297(83.7%)	298(84.2%)	0.001
ARB	191(54%)	203(57.2%)	196(55.2%)	192(54.1%)	0.811
ACEI	46(13%)	45(12.7%)	59(16.6%)	73(20.6%)	0.012
CCB	137(38.7%)	191(53.8%)	185(52.1%)	215(60.6%)	<0.001
β-blocker	86(24.3%)	116(32.7%)	138(38.9%)	174(49%)	<0.001
α-blocker	22(6.2%)	39(11%)	30(8.5%)	64(18%)	<0.001
SPC	60(16.9%)	70(19.7%)	64(18%)	70(19.7%)	0.729
Diuretics	103(29.1%)	122(34.5%)	124(34.9%)	164(46.3%)	<0.001
Hypoglycemic agents	173(48.9%)	180(50.8%)	174(49%)	184(52%)	0.812
Antiplatelet drugs	139(39.3%)	152(42.9%)	165(46.5%)	181(51.1%)	0.012
Lipid-lowering drugs	229(64.7%)	238(67.2%)	242(68.2%)	242(68.4%)	0.712
CKD (3–5)	195(55.1%)	246(69.5%)	256(72.1%)	281(79.4%)	<0.001
Primary Cr (umol/L)	91(71~114.25)	100.5(81.75~141.25)	105(83.7~162)	111.5(88.75~182.5)	<0.001
Primary eGFR [mL(/min × 1.73m^2)]	62.68±30.03	53.05±29.78	48.38±28.05	42.83±26.18	<0.001
WBC (10^9/L)	5.56±1.58	6.17±1.48	6.91±1.46	7.44±1.5	<0.001
Hemoglobin (g/L)	123.9±24.4	121.1±24.36	121.47±22.49	115.5±25.17	<0.001
Monocyte (10^9/L)	0.35(0.26~0.43)	0.43(0.36~0.52)	0.52(0.45~0.63)	0.64(0.51~0.77)	<0.001
Neutrophil (10^9/L)	2.87±0.91	3.59±0.92	4.35±1.04	5.23±1.27	<0.001
Lymphocyte (10^9/L)	2.11±0.79	1.89±0.65	1.78±0.58	1.32±0.47	<0.001
Glu (mmol/L)	5.28(4.68~6.78)	5.3(4.65~6.83)	5.41(4.7~6.75)	5.4(4.66~6.8)	0.71
UA (mmol/L)	411.55±119.85	439.96±114.71	436.18±124.79	439.17±136.08	0.006
K (mmol/L)	4.07±0.47	4.05±0.49	4.08±0.5	4.02±0.53	0.307
P (mmol/L)	1.28±0.31	1.25±0.31	1.26±0.3	1.21±0.33	0.019
Na (mmol/L)	141.34±2.87	141.52±3.21	141.16±3.01	140.67±3.99	0.004
Cl (mmol/L)	104.43±3.56	104.34±3.7	103.88±3.68	103.34±4.66	0.001
Albumin (g/L)	37±7.51	37.04±6.87	37.47±6.15	36.49±6.39	0.297
TC (mmol/L)	5.02±1.95	4.89±1.85	4.85±1.69	4.81±1.88	0.461
HDL (mmol/L)	1.21±0.42	1.22±0.4	1.16±0.38	1.17±0.38	0.067
LDL (mmol/L)	3.12±1.5	3.17±1.56	2.97±1.34	3.03±1.58	0.243
TG (mmol/L)	1.42(0.97~1.95)	1.445(0.9875~1.925)	1.41(0.95~2.23)	1.32(0.9~1.9)	0.179
LpA (g/L)	142(79~250.5)	145(79~285)	142(72.5~266)	168(90.5~330)	0.021
CRP (mg/L)	1.27(0.6~2.4)	1.4(0.7~2.9)	1.7(0.9~3.5)	2.3(1.28~4.81)	<0.001

Abbreviations: BMI, body mass index; CAD, coronary atherosclerotic heart disease; DM, diabetes; ARB, angiotensin receptor blocker; ACEI, angiotensin-converting enzyme inhibitors; CCB, calcium channel antagonist; SPC, single-pill combination; Cr, creatinine; eGFR, estimated glomerular filtration rate; Glu, glucose; K, potassium; UA, uric acid; Na, natrium; Cl, chlorine; P, phosphorus; TC, total cholesterol; LDL, low density lipoprotein; LpA, lipoprotein A.

Table 2 Logistic Regression Analysis of CKD 3–5 with Ln(SIRI)

	Crude Model		Model 1		Model 2
	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
Ln(SIRI)	1.91(1.61–2.28)	<0.001	1.56(1.29–1.88)	<0.001	1.59(1.29–1.95)	<0.001
Age			1.03(1.02–1.04)	<0.001	1.04(1.03–1.05)	<0.001
Female			0.39(0.29–0.51)	<0.001	0.38(0.28–0.51)	<0.001
Hypertension			2.18(1.64–2.89)	<0.001	1.97(1.45–2.69)	<0.001
CAD			0.57(0.38–0.85)	0.006	0.57(0.37–0.87)	0.01
DM			0.57(0.44–0.75)	<0.001	0.52(0.39–0.7)	<0.001
BMI					0.94(0.91–0.98)	0.004
UA					1.0(1–1.01)	<0.001
K					2.06(1.53–2.77)	<0.001
P					1.83(1.15–2.91)	0.01
LDL					0.9(0.81–1.0)	0.043

Notes: Crude model. Model 1: adjusted for Age Sex Smoker Drinker Hypertension CAD DM Stroke H.F A.F. Model 2: adjusted for Age Sex HDL BMI Smoker Drinker Hypertension CAD DM Stroke H.F A.F Primary Cr UA K P Na Cl Albumin LDL TG LpA.

Table 3 Cox Proportional-Hazard Analysis of Ln(SIRI) and CKD Progression

	Crude Model		Model 1		Model 2
	HR (95% CI)	P	HR (95% CI)	P	HR (95% CI)	P
ln(SIRI)	1.68(1.4,2.01)	<0.001	1.66(1.37,2)	<0.001	1.3(1.07,1.59)	0.009
Age			0.99(0.98,1)	0.024	0.99(0.98,1)	0.165
Sex			1.3(0.97,1.73)	0.075	1.64(1.20,2.25)	0.002
BMI			0.95(0.92,0.99)	0.012	0.99(0.95,1.03)	0.489
Hypertension			1.62(1.15,2.27)	0.006	1.5(1.04,2.16)	0.031
P					0.6(0.37,0.97)	0.038
Albumin					0.96(0.93,0.99)	0.002
HGB					0.98(0.97,0.99)	<0.001

Notes: Crude model. Model 1: adjusted for Age Sex Smoker Drinker Hypertension CAD DM Stroke H.F A.F BMI. Model 2: adjusted for Age Sex HDL BMI Smoker Drinker Hypertension CAD DM Stroke H.F A.F Primary Cr UA K P Na Cl Albumin LDL TG LpA CRP HGB.

Figure 2 Kaplan-Meier survival estimates in patients according to categories of ln(SIRI) are given.

Figure 3 HR (95% CI) for CKD progression associated with ln(SIRI).

Note: Multivariable models are adjusted for Age Sex HDL BMI Smoker Drinker HTN CAD DM Stroke H.F A.F Primary Cr UA K P Na CI Albumin LDL TG LpA CRP HGB.