Abstract
OBJECTIVE: Several studies illustrated high level of inflammation is an important factor affecting the poor prognosis of patients with chronic kidney disease. Inflammatory burden index (IBI) is a composite maker by incorporating a variety of inflammatory markers to facilitate more in-depth assessment for systemic inflammation. The purpose of this research is to examine the correlation between IBI and prognosis in CKD population of American adults. METHODS: This study included CKD patients recruited from the U.S. National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2010. The primary endpoints were identified as all-cause and cardiovascular mortality, with a median follow-up period of 83 (IQR 83-172) months. Associations between IBI and endpoints were explored using multivariable in-depth regressions, restricted cubic splines (RCS) and subgroup analyses. RESULTS: The research enrolled 3,975 subjects. During the follow-up period, there were 2,016 all-cause deaths and 628 cardiovascular deaths. Participants were divided into four groups based on IBI quartiles. Fully adjusted multivariate Cox regression analysis revealed increased IBI was associated with increased both all-cause and cardiovascular mortality risk [Quartile 4 vs. Quartile 1: all-cause mortality, HR = 1.37 (1.21-1.55); cardiovascular mortality, HR = 1.47 (1.17-1.84)]. The RCS analysis further supported a positive relationship between IBI and both endpoints. CONCLUSIONS: The IBI is strong correlated to the mortality of CKD individuals. Elevated levels of inflammation increased the risk of adverse clinical endpoints.