Kidney Week

Abstract: FR-PO1148

Association of High-Sensitivity C-Reactive Protein with CKD Severity in Nonobese Patients: Analysis of the 2017-2020 National Nutrition Health Examination Survey

Session Information

• CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Bunyawannukul, Issaree, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, United States

Issaree Bunyawannukul, MD

• Yongkiatkan, Panchanit, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Panchanit Yongkiatkan, MD

• Wongmat, Napat, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Napat Wongmat, MD

• Wareesawetsuwan, Nicha, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Nicha Wareesawetsuwan, MD

• Chamnarnphol, Natanon, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Natanon Chamnarnphol, MD

• Puyati, Weerinth, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Weerinth Puyati, MD

• Noree, Wanprapit, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Wanprapit Noree, MD

• Mohpichai, Nopavit, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Nopavit Mohpichai

• Kookanok, Chutawat, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Chutawat Kookanok, MD

• Kulthamrongsri, Narathorn, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Narathorn Kulthamrongsri, MD

• Wattanachayakul, Phuuwadith, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Phuuwadith Wattanachayakul, MD

• Gangeddula, Vishwaas Reddy, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Vishwaas Reddy Gangeddula

• Kim, Seonghyeon, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Seonghyeon Kim

• Shahnazarian, Christine T, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Christine T Shahnazarian

• Massihians, Monique, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Monique Massihians

• Lapadjyan, Mary E, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Mary E Lapadjyan

• Liu, Yangjiayi, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Yangjiayi Liu

• Park, David, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

David Park

• Ghaffarian, Bahaar S, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Bahaar S Ghaffarian

• Supapwanich, Palakorn, Excellent Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Palakorn Supapwanich, MD

• Anutrakulchai, Sirirat, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand

Sirirat Anutrakulchai, MD, PhD

• Lee, Kyung hee, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, California, United States

Kyung hee Lee, MD

• Kantachuvesiri, Surasak, Excellent Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Surasak Kantachuvesiri, MD

• Tantisattamo, Ekamol, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, United States

Ekamol Tantisattamo, MD, MPH, FASN

• Kaewsanga, Yosapan, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand

Yosapan Kaewsanga, MD

Background

Chronic kidney disease (CKD) is an inflammatory condition; however, the magnitude of the association between high-sensitivity C-reactive protein (CRP) and the severity of CKD among other inflammatory diseases is unknown. We aim to examine the association between CRP and CKD stage in patients with varying diabetes and obesity statuses.

Methods

A retrospective cross-sectional study using data from the 2017-2020 NHANES included participants with available CRP. The association between the quartile(Q) of CRP and 5 CKD stages (stages 1, 2, 3a, 3b, 4, and 5) stratified by self-reported diabetes and obesity status were examined by multiple ordered logistic regression analyses.

Results

Among 9,693 participants (mean age 49.6±18.6 years; 51.3% female), the median CRP was 1.94 mg/L. Diabetes and obesity were present in 14.7% and 41.7%, respectively. Most had CKD stage 1(60.3%), followed by stage 2(28.6%), 3a(6.5%), 3b(3.0%), 4(1.1%), and 5(0.5%). CRP was associated with higher CKD stage in a dose-dependent manner: compared to Q1, ORs were 1.47 (Q2), 1.47 (Q3), and 1.49 (Q4), all P<0.0001. After multivariable adjustment, Q2 (aOR 1.24, P=0.007) and Q3 (aOR 1.25, P=0.006), but not Q4 (aOR 1.14, P=0.139), remained significantly associated. In subgroup analysis, non-obese individuals without diabetes had increased CKD stage with CRP Q2 (aOR 1.24, P=0.032), while those with diabetes had higher odds in Q3 (aOR 1.85, P=0.045) and Q4 (aOR 2.18, P=0.025). A significant interaction was seen with race: Black participants aged ≥65 had attenuated associations (Pinteraction = 0.022 and 0.016).

Conclusion

CRP is positively associated with CKD stages in non-obese participants regardless of diabetes status, especially non-Black younger participants. Inflammatory state in combination with chronic inflammatory diseases particularly obesity should be controlled to mitigate the risk of CKD.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025wjeh7awg