In a study of patients with systemic rheumatic diseases, serum AG ratio was correlated with CRP and erythrocyte sedimentation rate concentrations, suggesting the significant association of serum AG ratio with inflammation. Low serum AG ratios have been observed in patients with rheumatoid arthritis and bronchiectasis, both of which are major chronic inflammatory diseases. Although the mechanism by which serum AG ratio has a significant association with unfavorable clinical outcomes has yet to be fully clarified, chronic inflammation has been regarded as a convincing explanation. Įmerging evidence indicates that serum albumin-to-globulin ratio (AG ratio), calculated by dividing serum albumin by serum globulin (total protein-albumin), is an effective prognostic indicator in chronic diseases. Higher levels of inflammatory markers, including white blood cell (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor receptor 1 (sTNF-R1), are significantly associated with a greater risk of declining kidney function. To date, various inflammatory markers have been studied to determine their association to CKD development. Apart from established traditional risk factors, chronic inflammation has been known to play a crucial role in the pathophysiology of CKD development. Considering higher risk of cardiovascular complications and premature mortality caused by CKD, identifying the risk factors of CKD development would be useful for clinical practice. The increasing incidence and prevalence of chronic kidney disease (CKD) had led to its global recognition as a preeminent public health problem.
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