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Association Between Systemic Immune-Inflammation Index and Risk of Chronic Kidney Disease; a Systematic Review and Meta-Analysis Publisher



Mojtahedi SY1, 2 ; Tavakolizadeh R3 ; Jafari M4 ; Shabanimirzaee H5 ; Safari M6 ; Ghodsi M7 ; Alamdari MG8 ; Ghanbari N9 ; Pourpashang P1, 2
Authors
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Authors Affiliations
  1. 1. Pediatric Chronic Kidney Disease Research Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pediatric Nephrology, Bahrami Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pediatrics, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pediatric Infectious Diseases, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Pediatric Endocrinology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Urology Department, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
  7. 7. Department of Pediatric Intensive Care, School of Medicine, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Pediatric Pulmonology, Tehran University of Medical Sciences, Bahrami Hospital, School of Medicine, Tehran, Iran
  9. 9. Emergency Division, Bahrami Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Nephropathology Published:2025


Abstract

Introduction: Inflammation is a hallmark feature of chronic kidney disease (CKD) and the systemic immune-inflammation index (SII) is a potent biomarker for assessing the inflammatory status. Taking note of these, the present systematic review and meta-analysis evaluated the correlation between SII and the risk for CKD. Materials and Methods: ProQuest, Embase, PubMed, Web of Science, Cochrane, and Google Scholar databases were searched until November 20, 2024, without any restriction applied. Data were analyzed in Stata v14.0. The results with P<0.05 were considered to be statistically significant. Results: Elevated SII values enhanced the overall risk of CKD (OR: 1.24; 95% CI: 1.52, 1.267), CKD risk in females (OR: 1.03; 95% CI: 1, 1.07), and CKD risk in the USA (OR: 1.27; 95% CI: 1.16, 1.38). Contrarily, no significant correlation was observed between SII and the risk for CKD among males (OR: 1.03; 95% CI: 0.99, 1.07) and in China (OR: 1.15; 95% CI: 0.98, 1.34). The second tertile (OR: 1.14; 95% CI: 1.05, 1.25), third tertile (OR: 1.49; 95% CI: 1.28, 1.73), third quartile (OR: 1.16; 95% CI: 1.08, 1.24), and fourth quartile (OR: 1.42; 95% CI: 1.27, 1.59) of the SII index enhanced the risk of CKD. Elevated SII values (OR: 1.43; 95% CI: 1.20, 1.70) enhanced the risk for CKD. Likewise, high SII values enhanced the risk for CKD in patients with diabetes mellitus (DM) (OR: 1.42; 95% CI: 1.21, 1.68), low-estimated glomerular filtration rate (eGFR) (OR: 1.27; 95% CI: 1.14, 1.40), and albuminuria (OR: 1.46; 95% CI: 1.08, 1.97), as well as in patients with BMI>30 kg/m² (OR: 1.05; 95% CI: 1.01, 1.09). Conclusion: Elevated SII values enhanced the risk of CKD, and the SII-CKD association was intensified in females, Americans, and patients with DM, low eGFR, albuminuria, and obesity. Accordingly, high SII levels are a robust indicator of CKD prognosis. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024619311) and Research Registry (UIN: reviewregistry1925,) websites. © 2025 The Author(s).
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