Atherosclerosis and chronic kidney disease (CKD) share several common antecedents.
However, the association between inflammatory markers and incident CKD is unknown.
We determined risk for incident CKD, defined by treatment for kidney failure or death
related to kidney disease, in 9,250 US adults aged 30 to 74 years who participated
in the Second National Health and Nutrition Examination Survey (NHANES II), a nationally
representative prospective cohort study with 17 years of follow-up.
After adjusting for age, race, sex, blood pressure, smoking, and body mass index,
there was a graded positive association with increasing total white blood cell (WBC)
count and risk for CKD (P for trend < 0.001; relative hazard (RH) highest versus lowest
quartile, 2.34; 95% confidence interval [CI], 1.30 to 4.19). This association remained
statistically significant after adjusting further for the presence of diabetes and
cardiovascular disease at baseline (RH, 2.01; 95% CI, 1.11 to 3.65). A similarly strong
and graded association with incident CKD was observed for hypoalbuminemia after adjusting
for age, race, sex, blood pressure, smoking, and body mass index (P for trend = 0.02;
RH lowest versus highest quartile, 1.91; 95% CI, 0.89 to 4.07) and additionally adjusting
for the presence of diabetes and cardiovascular disease at baseline (P for trend =
0.02; RH lowest versus highest, 2.05; 95% CI, 0.96 to 4.39).
In a nationally representative sample of US adults, elevated WBC count and hypoalbuminemia
were associated with future risk for CKD. These results support the hypothesis that
systemic inflammation is an independent risk factor for CKD.