Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease

TANG Leile; KANG Jianhao; LI Shaomin; DENG ying; LIU Xun

doi:10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0614

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Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease

Clinical Research | 更新时间：2025-12-05

- Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 46, Issue 6, Pages: 1041-1049(2025)
- 作者机构：
  
  1.中山大学附属第三医院心内科，广东广州 510630
  2.中山大学附属第三医院肾内科，广东广州 510630
- 作者简介：
  
  LIU Xun； E-mail： naturestyle@163.com
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0614
  CLC： R4
- Received：02 September 2025，
  
  Revised：2025-10-12，
  
  Accepted：06 November 2025，
  
  Published：20 November 2025
- 稿件说明：
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汤磊乐,康剑豪,李少敏等.全身免疫炎症指数对非透析慢性肾脏病进展的预测作用[J].中山大学学报（医学科学版）,2025,46(06):1041-1049.

TANG Leile,KANG Jianhao,LI Shaomin,et al.Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(06):1041-1049.
汤磊乐,康剑豪,李少敏等.全身免疫炎症指数对非透析慢性肾脏病进展的预测作用[J].中山大学学报（医学科学版）,2025,46(06):1041-1049. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0614.

TANG Leile,KANG Jianhao,LI Shaomin,et al.Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(06):1041-1049. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0614.

摘要

目的

本研究旨在探讨全身免疫炎症指数（SII）与肾功能之间的关系，并评估其对非透析慢性肾脏病（CKD）患者肾功能恶化风险的预测价值。

方法

纳入确诊为CKD的成年非透析患者。SII计算算式为外周血中性粒细胞计数（×10⁹/L）× 血小板计数（×10⁹/L）/淋巴细胞计数（×10⁹/L）。采用logistic回归与Cox回归模型，系统评估SII水平与CKD之间的关联。

结果

在该研究队列中，共有244例（17.2%）患者出现CKD进展。随着SII水平升高，晚期CKD及其进展的患病率亦随之增加，且差异有统计学意义；与此同时，估算肾小球滤过率（eGFR）和血红蛋白水平下降，而血清肌酐、C-反应蛋白及脂蛋白（a）水平则呈上升趋势。校正混杂因素后，SII 的自然对数（lnSII）与晚期 CKD 独立相关［OR=1.85，95% CI（1.46，2.35），

＜0.01］。Cox 比例风险模型进一步显示，SII 是 CKD 进展的独立预测因子［校正后 HR=1.35，95% CI（1.09，1.67），

＜0.01］。亚组分析提示，SII、性别与高血压在 CKD 进展中存在交互作用具有统计学意义。

结论

我们的研究结果挖掘了SII与肾功能之间的密切关联，并提示SII可作为CKD进展的潜在预测指标。

Abstract

Objective

Our study seeks to investigate the connection between systemic immune inflammatory index and renal function， as well as to assess its predictive capacity for the deterioration of renal function in chronic kidney disease patients with non-dialysis.

Methods

Adult non-dialyzing patients diagnosed with CKD were included. The computation of SII was calculated as the product of the peripheral blood neutrophil count （×10⁹/L） and platelet count （×10⁹/L）， divided by the lymphocyte count （×10⁹/L）. The logistic and Cox regression models were employed to scrutinize the linkage between SII levels and CKD.

Results

Out of the cohort， a significant portion of patients， numbering 244， which constitutes 17.2%， experienced progression of CKD. A notable upsurge in SII corresponded with an increased prevalence of advanced CKD and its progression， with significant difference. This trend was mirrored by a decline in the estimated glomerular filtration rate and hemoglobin levels， while serum creatinine， C-reactive protein， and lipoprotein（a） levels were on the rise. After adjusting for multiple variables， the natural logarithm of SII exhibited an independent association with advanced CKD ［OR=1.85 95% CI（1.46，2.35），

＜0.01］. Furthermore， Cox proportional hazards model

analysis revealed that SII acted as an independent predictor for CKD progression ［adjusted HR= 1.35， 95% CI（1.09，1.67），

＜ 0.01］. Subgroup analysis indicated a significant interaction among SII， gender， and hypertension concerning CKD progression.

Conclusion

Our findings underscore the robust relationship between SII and renal function， positioning SII as a potential forecaster for the progression of CKD.

关键词

Keywords

references

Yeh HC ， Lo YC ， Ting IW ， et al . 24-hour serum creatinine variation associates with short- and long-term all-cause mortality： a real-world insight into early detection of acute kidney injury ［J］. Sci Rep ， 2020 ， 10 （ 1 ）： 6552 .

Xs G ， Sq C ， Cy D ， et al . Association of post-procedural early （within 24h） increases in serum creatinine with all-cause mortality after coronary angiography .［J］. Clin Chim Acta ， 2017 ， 474 ： 96 - 101 .

Losito A ， Nunzi E ， Pittavini L ， et al . Cardiovascular morbidity and long term mortality associated with in hospital small increases of serum creatinine ［J］. J Nephrol ， 2018 ， 31 （ 1 ）： 71 - 77 .

Bernardi MH ， Ristl R ， Neugebauer T ， et al . Very early changes in serum creatinine are associated with 30-day mortality after cardiac surgery： a cohort study .［J］. Eur J Anaesthesiol ， 2020 ： 898 - 907 .

Zhang L ， Wang F ， Wang L ， et al . Prevalence of chronic kidney disease in China： a cross-sectional survey ［J］. Lancet ， 2012 ， 379 （ 9818 ）： 815 - 822 .

Chen S ， Liu H ， Liu X ， et al . Central obesity， C-reactive protein and chronic kidney disease： a community-based cross-sectional study in southern China ［J］. Kidney Blood Press Res ， 2013 ， 37 （ 4-5 ）： 392 - 401 .

Sesso HD ， Wang L ， Buring JE ， et al . Comparison of interleukin-6 and C-reactive protein for the risk of developing hypertension in women ［J］. Hypertension ， 2007 ， 49 （ 2 ）： 304 - 310 .

Savoia C ， Schiffrin E L . Inflammation in hypertension ［J］. Curr Opin Nephrol Hypertens ， 2006 ， 15 （ 2 ）： 152 - 158 .

Boos C J ， Lip G Y . Is hypertension an inflammatory process？［J］. Curr Pharm Des ， 2006 ， 12 （ 13 ）： 1623 - 1635 .

Di Napoli M ， Papa F . Systemic inflammation， blood pressure， and stroke outcome ［J］. J Clin Hypertens （Greenwich）， 2006 ， 8 （ 3 ）： 187 - 194 .

Stuveling EM ， Hillege HL ， Bakker SJ ， et al . C-reactive protein is associated with renal function abnormalities in a non-diabetic population ［J］. Kidney Int ， 2003 ， 63 （ 2 ）： 654 - 661 .

Huang H ， Liu Q ， Zhu L ， et al . Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer ［J］. Sci Rep ， 2019 ， 9 （ 1 ）： 3284 .

Zhong JH ， Huang DH ， Chen ZY . Prognostic role of systemic immune-inflammation index in solid tumors： a systematic review and meta-analysis ［J］. Oncotarget ， 2017 ， 8 （ 43 ）： 75381 - 75388 .

Hung SP ， Chen PR ， Ho TY ， et al . Prognostic significance of the preoperative systemic immune-inflammation index in patients with oral cavity squamous cell carcinoma treated with curative surgery and adjuvant therapy ［J］. Cancer Med ， 2021 ， 10 （ 2 ）： 649 - 658 .

Drawz PE ， Beddhu S ， Bignall ON ， et al . KDOQI US Commentary on the 2021 KDIGO clinical practice guideline for the management of blood pressure in CKD ［J］. Am J Kidney Dis ， 2022 ， 79 （ 3 ）： 311 - 327 .

Oh TR ， Choi HS ， Kim CS ， et al . Hyperuricemia has increased the risk of progression of chronic kidney disease： propensity score matching analysis from the KNOW-CKD study ［J］. Sci Rep ， 2019 ， 9 （ 1 ）： 6681 .

Furtado R ， Raz I ， Goodrich E L ， et al . Efficacy and safety of dapagliflozin in type 2 diabetes according to baseline blood pressure： observations from DECLARE-TIMI 58 trial ［J］. Circulation ， 2022 ， 145 （ 21 ）： 1581 - 1591 .

Kadatane SP ， Satariano M ， Massey M ， et al . The role of inflammation in CKD ［J］. Cells ， 2023 ， 12 （ 12 ）， 1581 .

Denker M ， Boyle S ， Anderson AH ， et al . Chronic renal insufficiency cohort study （CRIC）： overview and summary of selected findings ［J］. Clin J Am Soc Nephrol ， 2015 ， 10 （ 11 ）： 2073 - 2083 .

Kaminska J ， Stopinski M ， Mucha K ， et al . IL 6 but not TNF is linked to coronary artery calcification in patients with chronic kidney disease ［J］. Cytokine ， 2019 ， 120 ： 9 - 14 .

Li X ， Wu TT ， Chen J ， et al . Elevated expression levels of serum insulin-like growth factor-1， tumor necrosis factor-alpha and vascular endothelial growth factor 165 might exacerbate type 2 diabetic nephropathy ［J］. J Diabetes Investig ， 2017 ， 8 （ 1 ）： 108 - 114 .

Liu BC ， Tang TT ， Lv LL ， et al . Renal tubule injury： a driving force toward chronic kidney disease ［J］. Kidney Int ， 2018 ， 93 （ 3 ）： 568 - 579 .

Schaub JA ， Venkatachalam MA ， Weinberg JM . Proximal tubular oxidative metabolism in acute kidney injury and the transition to CKD ［J］. Kidney360 ， 2021 ， 2 （ 2 ）： 355 - 364 .

Amdur RL ， Feldman HI ， Gupta J ， et al . Inflammation and progression of CKD： the CRIC study ［J］. Clin J Am Soc Nephrol ， 2016 ， 11 （ 9 ）： 1546 - 1556 .

Dang K ， Wang X ， Hu J ， et al . The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease： NHANES 2003-2018 ［J］. Cardiovasc Diabetol ， 2024 ， 23 （ 1 ）： 8 .

Zhang S ， Chen N ， Ma L . Lactate-to-albumin ratio： a promising predictor of 28-day all-cause mortality in critically Ill patients with acute ischemic stroke ［J］. J Stroke Cerebrovasc Dis ， 2024 ， 33 （ 6 ）： 107536 .

Ghafori SS ， Yousefi Z ， Bakhtiari E ， et al . Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression： a narrative review ［J］. Brain Behav Immun Health ， 2024 ， 36 ： 100734 .

Salciccia S ， Frisenda M ， Bevilacqua G ， et al . Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer： a meta-analysis and systematic review ［J］. Asian J Urol ， 2024 ， 11 （ 2 ）： 191 - 207 .

Shi X ， Yang L ， Bai W ， et al . Evaluating early lymphocyte-to-monocyte ratio as a predictive biomarker for delirium in older adult patients with sepsis： insights from a retrospective cohort analysis ［J］. Front Med （Lausanne）， 2024 ， 11 ： 1342568 .

Sevencan N ， Ozkan A . Associations between neutrophil/lymphocyte ratio， platelet/lymphocyte ratio， albuminuria and uric acid and the estimated glomerular filtration rate in hypertensive patients with chronic kidney disease stages 1-3 ［J］. Arch Med Sci ， 2019 ， 15 （ 5 ）： 1232 - 1239 .

Burlacu A ， Namolovan CA ， Brinza C ， et al . Neutrophil-to-lymphocyte ratio （NLR）-independent prognostic marker of renal function decline in chronic kidney disease： a systematic review and meta-analysis ［J］. Clin Med ， 2025 ， 14 （ 19 ）： 6822 .

Yoshitomi R ， Nakayama M ， Sakoh T ， et al . High neutrophil/lymphocyte ratio is associated with poor renal outcomes in Japanese patients with chronic kidney disease ［J］. Ren Fail ， 2019 ， 41 （ 1 ）： 238 - 243 .

Zeng M ， Liu Y ， Liu F ， et al . J-shaped association of platelet-to-lymphocyte ratio with 5-year mortality among patients with chronic kidney disease in a prospective cohort study ［J］. Int Urol Nephrol ， 2020 ， 52 （ 10 ）： 1943 - 1957 .

Yuan Q ， Wang J ， Peng Z ， et al . Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease： results from the Chinese Cohort Study of Chronic Kidney Disease （C-STRIDE）［J］. J Transl Med ， 2019 ， 17 （ 1 ）： 86 .

Zhao Z ， Zhang X ， Sun T ， et al . Prognostic value of systemic immune-inflammation index in CAD patients： systematic review and meta-analyses ［J］. Eur J Clin Invest ， 2024 ， 54 （ 2 ）： e14100 .

Zhang Y ， Liu W ， Yu H ， et al . Value of the systemic immune-inflammatory index （SII） in predicting the prognosis of patients with peripartum cardiomyopathy ［J］. Front Cardiovasc Med ， 2022 ， 9 ： 811079 .

Pang J ， Ding N ， Yin N ， et al . Systemic immune-inflammation index as a prognostic marker in HER2-positive breast cancer patients undergoing trastuzumab therapy ［J］. Sci Rep ， 2024 ， 14 （ 1 ）： 6578 .

Kouhpayeh H . Clinical features predicting COVID-19 mortality risk ［J］. Eur J Transl Myol ， 2022 ， 32 （ 2 ）： 10268 .

Mezger M ， Nording H ， Sauter R ， et al . Platelets andimmune responses during thromboinflammation ［J］. Front Immunol ， 2019 ， 10 ： 1731 .

Hamrahian SM ， Falkner B . Hypertension in chronic kidney disease ［J］. Adv Exp Med Biol ， 2017 ， 956 ： 307 - 325 .

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Department of Emergency Medicine； The Third Affliated Hospital of Sun Yat-sen University

Pediatric Hospital of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine

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