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June 7, 2026Diabetes

Higher hsCRP linked to ~11% greater CV risk per doubling, primarily with elevated BMI.

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Why the study?

Inflammation is a key driver of residual CV risk in CKD, but the extent of its association with obesity in this population is underexplored.

Does finerenone reduce composite CV events irrespective of baseline hsCRP and BMI in adults with CKD and T2D?

Population

12,864 adults with CKD and T2D

Comparison

hsCRP levels overall and by BMI categories

Design

Participant-level pooled analysis

Key result

Higher baseline hsCRP levels were associated with a higher rate of composite CV events (aHR per hsCRP doubling 1.11; 95% CI 1.07-1.14), primarily among persons with elevated BMI.

Authors

JOJohn OstrominskiGFGERASIMOS FILIPPATOSPRPETER ROSSING

Discussion

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Overview

Highlights BMI-dependent inflammatory CV risk in CKD/T2D; confirms residual pathway but leaves targeted anti-inflammatory strategies open.

Key Points

  • This research aims to explore the connection between inflammation and obesity, particularly regarding cardiovascular risks in individuals with chronic kidney disease and type 2 diabetes.
  • Participant-level pooled analysis from the FIDELITY program
  • Assessed hsCRP and BMI association among 12,864 adults with CKD and type 2 diabetes
  • Evaluated cardiovascular outcomes based on hsCRP levels and BMI categories.
  • 53% of participants had elevated hsCRP (≥2 mg/L) at baseline.
  • Elevated hsCRP levels correlated with a higher rate of composite cardiovascular events (aHR 1.11; 95% CI, 1.07-1.14).
  • Risk associations were significant particularly in those with elevated BMI (Pinteraction=0.002).

Study Design

Type

Observational (n=12,864)

Structured PICO

Does finerenone reduce composite CV events irrespective of baseline hsCRP and BMI in adults with CKD and T2D?

P
Population
12,864 adults with chronic kidney disease and type 2 diabetes (mean age 65 years, 30% female) from the FIDELITY program.
E
Exposure
Finerenone
O
Outcome
Composite CV eventscomposite

Main Result

Hazard Ratio: 1.11 (95% CI 1.07–1.14)

In patients with CKD and T2D, low-grade inflammation is associated with increased CV risk, particularly in those with overweight/obesity, but the CV benefits of finerenone remain consistent regardless of baseline hsCRP or BMI.

Cite This Study

Ostrominski et al. (2026) conducted an observational in Chronic Kidney Disease and Type 2 Diabetes (n=12,864). Higher baseline hsCRP levels vs. Lower baseline hsCRP levels was evaluated on composite CV events (aHR 1.11, 95% CI 1.07-1.14). Higher baseline hsCRP levels were associated with a higher rate of composite CV events (aHR per hsCRP doubling 1.11; 95% CI 1.07-1.14), primarily among persons with elevated BMI.

synapsesocial.com/papers/6a250c1c7def13d035e1c19dhttps://doi.org/10.2337/db26-1764-p
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