Evidence map›Paper›PMID 40128977›Full record

ArticleEnvironmental health and preventive medicine2025

Association of C-reactive protein to albumin ratio with all-cause and cardiovascular mortality in patients with chronic kidney disease stages 3-5.

Jie Liu, Jin Zhao, Jinguo Yuan, Zixian Yu, Yunlong Qin, Yan Xing, Qiao Zheng, Yueru Zhao, Xiaoxuan Ning, Shiren Sun

Abstract read
In one paragraph

Article in Environmental health and preventive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jie LiuDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Jin ZhaoDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Jinguo YuanDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Zixian YuDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Yunlong QinDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Yan XingDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Qiao ZhengDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.
Yueru ZhaoMedicine School of Xi'an Jiaotong University.
Xiaoxuan NingDepartment of Geriatrics, Xijing Hospital, Fourth Military Medical University.
Shiren SunDepartment of Nephrology, Xijing Hospital, The Fourth Military Medical University.ORCID http://orcid.org/0000-0001-8580-9746

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) poses a major global health challenge, often foreshadowing poor patient outcomes. The C-reactive protein to albumin ratio (CAR) serves as a pivotal biomarker, demonstrating a strong correlation with adverse outcomes in cardiovascular disease (CVD). This study sought to examine the correlation between CAR and the risk of all-cause and cardiovascular mortality in patients with CKD stages 3-5.

methodsThis study utilized data of CKD patients from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010, with follow-up to December 31, 2019. The optimal CAR cutoff value was identified utilizing the method of maximally selected rank statistics. Multivariable Cox proportional hazards regression model, restricted cubic splines (RCS) model, and subgroup analysis were employed to assess the association between CAR and mortality among CKD patients.

resultsDuring a median (with interquartile range) follow-up period of 115 (112,117) months among 2,841 CKD individuals, 1,893 deaths were observed, including 692 deaths due to CVD events. Based on the RCS analysis, a non-linear correlation was observed between CAR and mortality. Using 0.3 as the optimal CAR cutoff value, the cohort was divided into high and low groups. In the fully adjusted model, CKD patients with high CAR values exhibited an elevated risk of all-cause mortality (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.28-1.83, P < 0.001) and cardiovascular mortality (HR 1.48, 95% CI 1.08-2.02, P = 0.014). Compared to the population aged >65 years (HR 1.32, 95% CI 0.99-1.76, P = 0.064), the risk of cardiovascular mortality was significantly higher in those aged ≤65 years (HR 2.19, 95% CI 1.18-4.09, P = 0.014) with elevated CAR levels.

conclusionsA notable correlation exists between the elevation of CAR and increased all-cause and cardiovascular mortality, suggesting its potential as an independent indicator for evaluating the prognosis of patients with CKD stages 3-5.

Indexed as

Cardiovascular DiseasesC-Reactive ProteinRenal Insufficiency, ChronicSerum AlbuminAdultAgedBiomarkersFemaleHumansMaleMiddle AgedNutrition SurveysUnited StatesBiomarkersC-Reactive ProteinSerum AlbuminCardiovascular diseaseChronic kidney diseaseC-reactive protein to albumin ratioMortalityNHANES

Identifiers

PMID40128977
PMCPMC11955801

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.