Table1_Association of systemic inflammation response index with all-cause mortality as well as cardiovascular mortality in patients with chronic kidney disease.docx

BackgroundChronic Kidney Disease (CKD) stands as a formidable health challenge, recognized not only for its growing prevalence but also for its association with elevated mortality rates. Emerging evidence suggests that CKD is inherently linked to inflammatory processes, marking it as an inflammatory disorder. In this landscape, the systemic inflammatory response index (SIRI) emerges as a novel inflammation marker, yet to be applied for assessing the risk of mortality in CKD patients.
ObjectiveThis study aims to investigate the prognostic significance of the SIRI in all-cause and cardiovascular disease (CVD) mortality among patients with CKD.
MethodThis study conducted a retrospective observational study using the National Health and Nutrition Examination Survey (NHANES) database, encompassing data from 1999 to 2018. This analysis included 9,115 CKD patients, categorized based on SIRI quartiles. Key outcomes were all-cause and CVD mortality, analyzed using Kaplan–Meier survival curves, restricted cube splines (RCS) and cox proportional hazards models.
ResultIn this study of 9,115 CKD patients, the Kaplan–Meier survival analysis revealed a greater incidence of all-cause death among groups with higher SIRI (P-log rank <0.001). In the fully adjusted model (Model 3), each unit increase in SIRI led to a 20% increase in the risk of all-cause mortality. Additionally, higher SIRI quartiles (Q3 and Q4) were associated with increased risk compared to the lowest quartile (Q1) (Q3: HR: 1.16, 95% CI: 1.01–1.34; Q4: HR: 1.63, 95% CI: 1.40–1.90; P for trend <0.001). Similarly, for CVD mortality, each unit increase in SIRI in Model 3 increased the risk by 33%, with Q3 and Q4 showing higher risk than Q1 (Q3: HR: 1.39, 95% CI: 1.11–1.70; Q4: HR: 2.26, 95% CI: 1.72–2.98; P for trend <0.001).
ConclusionSIRI was positively associated with all-cause and CVD mortality in patients with CKD.

背景：慢性肾脏病（Chronic Kidney Disease, CKD）是一项严峻的公共卫生挑战，其不仅患病率持续攀升，还与较高的死亡率密切相关。现有新兴研究证据表明，慢性肾脏病本质上与炎症反应紧密关联，可被归类为炎症性疾病。在此研究背景下，全身炎症反应指数（Systemic Inflammatory Response Index, SIRI）作为一种新型炎症标志物，目前尚未被应用于慢性肾脏病患者的死亡风险评估。
目的：本研究旨在探讨全身炎症反应指数（SIRI）对慢性肾脏病患者全因死亡及心血管疾病（Cardiovascular Disease, CVD）死亡的预后价值。
方法：本研究利用美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）1999至2018年的队列数据开展回顾性观察研究，共纳入9115例慢性肾脏病患者，并根据SIRI四分位数进行分组。本研究的主要结局指标为全因死亡及心血管疾病死亡，分析方法包括Kaplan-Meier生存曲线、限制性立方样条（Restricted Cube Splines, RCS）以及Cox比例风险模型。
结果：在本研究纳入的9115例慢性肾脏病患者中，Kaplan-Meier生存分析结果显示，SIRI水平更高的组别全因死亡发生率显著更高（对数秩检验P<0.001）。在完全校正模型（模型3）中，SIRI每升高1个单位，全因死亡风险升高20%；与最低四分位组（Q1）相比，较高的SIRI四分位组（Q3和Q4）全因死亡风险显著升高（Q3：风险比HR=1.16，95%置信区间CI:1.01~1.34；Q4：HR=1.63，95%CI:1.40~1.90；趋势检验P<0.001）。针对心血管疾病死亡风险，模型3中SIRI每升高1个单位，死亡风险升高33%；同样，Q3和Q4组的死亡风险均高于Q1组（Q3：HR=1.39，95%CI:1.11~1.70；Q4：HR=2.26，95%CI:1.72~2.98；趋势检验P<0.001）。
结论：慢性肾脏病患者的SIRI水平与全因死亡及心血管疾病死亡风险呈正相关。