Reduction in Serum High-Sensitivity C-Reactive Protein Favors Kidney Outcomes in Patients with Impaired Fasting Glucose or Diabetes

Abstract

Objective. We aimed to evaluate whether the reduction in serum high-sensitivity C-reactive protein (hs-CRP) favors kidney outcomes. Methods. This study was a subanalysis including patients with impaired fasting glucose or diabetes of the Kailuan cohort study. The predictor was based on two consecutive visits of hs-CRP levels in 2006 and 2008. A total of 3924 patients with hs-CRP≥3 mg/L in 2006 were divided into two groups according to whether the levels of hs-CRP were reduced in 2008: Group 1: no reduction: hs-CRP≥3 mg/L in 2008; Group 2: reduction: hs-CRP<3 mg/L in 2008. Kidney outcomes include kidney function decline and development and progression of proteinuria and were followed up until the end of 2015. Results. There were 3905, 2049, and 493 patients included into our analysis for the outcomes of kidney function decline and the development and progression of proteinuria, respectively. A total of 398, 297, and 47 events occurred after 5 years of follow-up, respectively. Cox regression revealed that patients with reduction in hs-CRP have lower risk of kidney function decline (HR 0.71, 95% CI 0.57-0.89, and P=0.002) and development of proteinuria (0.77, 0.61-0.99, and P=0.038) after controlling for potential confounders as compared to those with no reduction in hs-CRP levels. Conclusions. Reduction in serum hs-CRP levels favors kidney outcomes in patients with impaired fasting glucose or diabetes.

Impact of semaglutide on high-sensitivity C-reactive protein: exploratory patient-level analyses of SUSTAIN and PIONEER randomized clinical trials

“…Furthermore, baseline eGFR categories were shown to have no effect on the hsCRP ratio to baseline at end-of-treatment. This is a clinically relevant result, because reductions in hsCRP have been linked to improved kidney outcomes [ 43 ]. In general, the pathological milieu is altered in patients with kidney impairment and may lead to differences in responses to drugs [ 44 ], although the renal safety of semaglutide presented in the PIONEER 5 primary publication was consistent with the suggested kidney-protective effects of GLP-1RAs overall in this population [ 21 ].…”

Neutrophil-lymphocyte ratio, high-sensitivity C-reactive protein and monocyte chemoattractant protein-1 as novel markers for patients with type 2 diabetic kidney disease

“…Insulin resistance can lead to increased synthesis of hs-CRP, and then activate the complement to produce a large number of in ammatory mediators and release oxygen radicals, which can impair vascular endothelial cell function and increase vascular permeability, leading to albuminuria production and kidney function reduced. The study found that hs-CRP was independently associated with the risk of decreased kidney function and the development of albuminuria [22], and reducing serum hs-CRP levels is bene cial for improving patients' kidney outcomes [23]. Tang M et al [24] demonstrated that hs-CRP levels were positively correlated with the incidence of T2DKD, which may provide predictive and diagnostic values in clinical practice.…”

Association of C-Reactive Protein with Risk of Complications of diabetic nephropathy

“…As well as a recent study revealed that CRP could exacerbate epithelialmesenchymal transformation after binding with apoptotic cells via the activation of the Wnt/βcatenin and ERK1/2 which act to regulated kinase (ERK) pathways play important roles in the incidence of diabetic renal. disease [26].…”