# Verhoogd hs-CRP voorspelt cardiorenale uitkomsten bij matige tot ernstige CKD

*geplaatst 2026-10-25 · Nierziekte · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · doi 10.1093/ndt/gfag240 · https://hartvaat.nl/2026/10/16/verhoogd-hs-crp-voorspelt-cardiorenale-uitkomsten-bij-matige-tot-ernstige-ckd/*

In een nationaal Zweeds cohort van 23.008 volwassenen met matige tot ernstige chronische nierziekte (CKD-stadia 3-5) werd de prognostische waarde van verhoogd hs-CRP onderzocht. Tijdens een mediane follow-up van 3,9 jaar was een hs-CRP ≥2 mg/L geassocieerd met een verhoogd risico op MACE (HR 1,20), hartfalenhospitalisatie (HR 1,29), acute nierinsufficiëntie (HR 1,28) en overlijden (HR 1,43). Deze associaties waren consistent over verschillende CKD-stadia en bij patiënten met en zonder ASCVD. Het onderzoek ondersteunt het monitoren van hs-CRP als inflammatoire marker in de cardiorenale zorg.

## English: High sensitivity C-reactive protein and the risk of cardio-kidney outcomes in adults with moderate to severe chronic kidney disease: a nationwide study.

In a nationwide Swedish cohort of 23,008 adults with moderate to severe chronic kidney disease (CKD stages 3-5), researchers evaluated the prognostic value of elevated high-sensitivity C-reactive protein (hs-CRP). Over a median follow-up of 3.9 years, hs-CRP ≥2 mg/L was associated with higher risks of major adverse cardiovascular events (HR 1.20), heart failure hospitalization (HR 1.29), acute kidney injury (HR 1.28), and all-cause mortality (HR 1.43). These associations remained consistent across CKD stages and in patients with or without established atherosclerotic cardiovascular disease. The findings support routine hs-CRP monitoring as a prognostic marker in cardiorenal care.

## Abstract (original, from the publication)

BACKGROUND AND HYPOTHESIS: The burden and prognostic significance of inflammation in chronic kidney disease (CKD) remains poorly characterized, with prior studies yielding conflicting estimates of the association between elevated high-sensitivity C-reactive protein (hsCRP) and cardio-kidney outcomes. METHODS: Observational nationwide study of 23,008 adults with CKD stages 3-5 attending nephrology care and enrolled in the Swedish Renal Registry (2008-2023). Inflammation was assessed longitudinally via 94,500 repeated hsCRP registrations. Time-varying, cause-specific Cox models accounting for competing risks estimated associations with study outcomes, which included major adverse cardiovascular events (MACE), heart failure (HF) hospitalization, acute kidney injury (AKI), kidney failure requiring replacement therapy (KFRT) and all-cause mortality. Pre-defined stratifiers were atherosclerotic cardiovascular disease (ASCVD) history and CKD stage. RESULTS: Mean age was 71 years, 65% were male, and median estimated glomerular filtration rate was 25 mL/min/1.73 m². Median hsCRP was 4.0 (IQR 1.9-7.0) mg/L, and 75% of participants had hsCRP≥2. Over median 3.9 (IQR 2.0-6.7) years, hsCRP ≥2 mg/L was associated with higher rates of all outcomes: hazard ratio 1.20 (95% confidence interval 1.12-1.28) for MACE (n=5,480 events); 1.29 (1.22-1.37) for HF hospitalization (n=8,173); 1.28 (1.18-1.38) for AKI (n=3,943); 1.09 (1.02-1.15) for KFRT (n=6,177); and 1.43 (1.37-1.50) for mortality (n=12,645). In spline analyses, associations were steeper at lower hsCRP levels and flatter thereafter for all outcomes except KFRT, where the hsCRP-response relationship was relatively flat. Associations with MACE, HF, AKI and mortality were consistent regardless of ASCVD status and CKD stage. Associations with KFRT were inconsistent across CKD stages. CONCLUSION: In this nationwide cohort of adults with moderate to severe CKD receiving nephrology care, inflammation was common, and higher hsCRP levels were associated with adverse cardiovascular and kidney outcomes, as well as mortality. Although associations were less consistent for KFRT, these findings collectively support the utility of hsCRP monitoring in this population.

Auteurs: Faizan Mazhar, Minjung Han, Katherine R Tuttle, Aurora Caldinelli, Magnus Fugger, Sofia Gerward, Jimmi Mathisen, Brendon L Neuen, Marie Evans, Juan-Jesus Carrero

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Bron: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, https://doi.org/10.1093/ndt/gfag240. Bijgewerkt 2026-10-18T01:17:52Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.