Elevated systemic inflammation may reflect worsening kidney dysfunction in specific cardiometabolic subgroups. Findings presented at the American Heart Association (AHA) 2025 Scientific Sessions and published in Circulation examined the association between high-sensitivity CRP levels and CKD staging, stratified by HTN and obesity status.

The retrospective cross-sectional analysis included 9,693 adults from the National Health and Nutrition Examination Survey (NHANES) 2017 to 2020. The mean age measured 50 years and 51.3% were female. Median estimated glomerular filtration rate (eGFR) was 98 mL/min/1.73 m². CRP quartiles ranged from 0.31 mg/L in quartile one to 6.5 mg/L in quartile four.

Adjusted ordered logistic regression demonstrated higher odds of advancing one CKD stage among participants in CRP quartiles two, three and four compared with quartile one (adjusted odds ratio [OR] 1.45, 1.46 and 1.32, respectively; P<0.01 for all comparisons).

Subgroup evaluation indicated that the association was evident only in adults with HTN who were not obese (adjusted OR 1.53 to 1.77; P<0.05). Effect modification by race and age revealed reduced odds of CKD stage worsening in Black adults aged 65 years or older (Pinteraction 0.038).

These findings indicate that elevated CRP independently correlates with more advanced CKD staging in non-obese hypertensive adults. Inflammation-based risk stratification may enhance early recognition of progressive kidney disease in these populations while acknowledging heterogeneity across demographic subgroups.