Objective: This study aimed to examine the relationship between the C-reactive protein-albumin-lymphocyte (CALLY) index, a composite measure of inflammation, nutritional status, and immune function, and chronic kidney disease (CKD). Methods: The study employed a population-based cohort retrospective analysis design, integrating the NHANES dataset (n = 24,538) and the clinical cohort of China (n = 7,102). The present study sought to assess the association and predictive efficacy of the CALLY index for CKD. To this end, multi-stage logistic regression modeling, receiver operating characteristic (ROC) analysis, and restricted cubic spline (RCS) analysis were employed. The analysis controlled for demographic factors, lifestyle, and metabolic diseases. Results: The study indicated a negative correlation between the CALLY index and CKD, with a 1% reduction (odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.99-0.99) and a 3% reduction (OR = 0.97, 95% CI = 0.96-0.98) in CKD risk for every 1-unit increase in the index, respectively, in the U.S. and Chinese cohorts. The ROC analyses yielded a multifactorial-adjusted AUC for the U.S. cohort of 0.803 (95% CI: 0.795-0.810), and the Chinese cohort was 0.676 (95% CI: 0.657-0.695). Threshold effect analyses demonstrated that the risk significantly reduced when CALLY<2.313 (OR=0.77 for the US cohort and OR=0.63 for the Chinese cohort), and the association disappeared above the threshold. Subgroup analyses indicated that hypertension and obesity status modified the predictive efficacy of the CALLY index. Conclusion: The CALLY index demonstrates a negative correlation with CKD. Its cross-cohort robustness and threshold effect provide a foundation for implementing early screening and stratified intervention strategies. However, the index's clinical translational value remains to be validated in future studies.
Zhang et al. (Mon,) studied this question.