ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Renal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1605543
This article is part of the Research TopicModifiable Risk Factors for Chronic Kidney Disease ProgressionView all 8 articles
Systemic Immune Inflammatory Index and Mortality in Chronic Kidney Disease
Provisionally accepted
- 1Hyperbaric oxygen Department,First Hospital of Jilin University, Jilin, China
- 2First Hospital of Jilin University, Jilin, China
- 3Department of Anesthesiology, First Hospital of Jilin University,Chang chun,Jilin 130021,China, Changchun, China
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Background: Chronic kidney disease (CKD) is common and linked to highermortality rates, but its relationship with the the systemic immunoinflammatory index(SII) remains unclear, highlighting the need for further research. Methods: The SII is calculated by multiplying the counts of platelets and neutrophils, followed by dividing that product by the lymphocyte count. A diagnosis of CKD ismade when the estimated glomerular filtration rate (eGFR) is below 60 mL/min/1.73m². To further analyze the data, a multivariable Cox regression analysis, along withsubgroup assessments, was performed. Analysis of survival data and threshold effectssuggests that SII is a crucial independent factor related to mortality from all causesand cardiovascular issues in individuals with chronic kidney disease. Results: The study comprised a total of 46,620 individuals, with a weighted averageage (standard error) of 47.00 (0.18) years. Among individuals over 20 years oldsuffering from CKD, the log-transformed SII demonstrated a nonlinear relationship,revealing a U-shaped correlation with the mortality rates associated with all causes aswell as cardiovascular diseases (CVD). When SII.log as the log values rise, thelikelihood of dying from all causes and cardiovascular issues initially shows a decline. Nevertheless, this pattern shifts, leading to an increased risk of mortality once acertain limit is surpassed. The evaluation of threshold impacts identified importantlevels starting at 6.06 and 6.25, which corresponded to the lowest observed mortalityrisk when evaluated through the SII.log values. The likelihood of mortality from allcauses escalated once these limits were surpassed (HR 0.75, 95% CI 0.64-0.88; HR1.74, 95% CI 1.55-1.95). The likelihood of mortality due to CVD also elevated (HR1.01, 95% CI 0.78-1.31; HR 1.91, 95% CI 1.50-2.44). Higher SII levels correlatedwith decreased survival and longevity. In CKD patients over 45 years, SII reliablypredicted all-cause mortality (statistically significant) and was linked tocardiovascular and cancer deaths (not statistically significant). Conclusions: SII is an easily obtainable marker that may predict mortality in CKDpatients over 45. More longitudinal research is needed to confirm its link withmortality rates (all causes, cardiovascular, and cancer) due to current limitations.
Keywords: Chronic Kidney Disease, Systemic immune-inflammatory index, cardiovascular disease, Cancer mortality, All Causes Mortality
Received: 03 Apr 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Ma, Yu, Jia, Wang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hu Shan Wang, Department of Anesthesiology, First Hospital of Jilin University,Chang chun,Jilin 130021,China, Changchun, China
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