Systemic Immune-inflammation Index Tied to Mortality in CKD

There is a J-shaped association between systemic immune-inflammation index (SII) levels and all-cause mortality in patients with chronic kidney disease (CKD), according to a study published online Sept. 10 in Immunity, Inflammation and Disease.

Meng Jia, from the Shanghai University of Traditional Chinese Medicine, and colleagues investigated the association between SII and all-cause mortality in individuals with CKD. The analysis included 9,303 people with CKD participating in the National Health and Nutrition Examination Survey (1999 to 2018).

The researchers found that during a median follow-up of 86 months, there was a distinctive J-shaped relationship between SII level and all-cause mortality. The nadir was seen at an SII level of 478.93 in the second quartile. The risk for all-cause mortality increased per increment of one standard deviation of SII once SII exceeded 478.93 (hazard ratio, 1.13). There was an association between elevated SII and an increased risk for all-cause mortality among patients with CKD (quartile 4 versus quartile 2: hazard ratio, 1.23). The correlation between SII and CKD mortality was particularly pronounced for participants older than 60 years and for individuals with diabetes. When removing the extreme 5 percent outliers of SII, there was a linear positive association between SII and all-cause mortality.

"The SII index, encompassing platelet, neutrophil, and lymphocyte counts, offers a more comprehensive representation of the equilibrium between inflammatory status and host immune response," the authors write.

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