Objective: As adipose tissue releases inflammatory cytokines, obesity is associated with elevated C-reactive protein (CRP) levels in the general population. We examined the cross-sectional association of body mass index (BMI) with CRP in patients with chronic kidney disease (CKD). Design: Cross-sectional study. Setting and Participants: Ninety-four CKD patients with varying levels of renal function seen at the University of Utah outpatient renal clinic were studied. Methods: Data on demographics (age, gender, race), comorbiclity (diabetes mellitus, hypertension, myocardial infarction/angina, cerebrovascular disease, peripheral vascular disease, and smoking) and anthropometry (height and weight) were obtained by patient interview and chart reviews. High-sensitivity CRIP was measured by the N-latex assay on a BN II nephelometer. Main Outcome Measure: Risk factors of high CRP. Results: In a multivariable logistic regression model, when compared with patients with a BMI < 25, the odds of CRP 3.0 mg/L were 2.5-fold (95% CI, 1.02 to 5.99) higher in patients with BMI greater than or equal to 30. In a stepwise multiple linear regression model, IBMI (regression coefficient [01 0.06; 95% CI, 0.03 to 0.1; P <.01), serum creatinine (beta = 0,16; 95% CI, 0.04 to 0.3; P -.01) and age (P = 0.01; 95% CI, -0.001 to 0.03; P =.05) were significantly associated with log transformed CRP. Conclusion: These data suggest that as in the general population, in CKID patients, obesity, a traditional risk factor for atherosclerosis, is associated with inflammation, a novel risk factor for atherosclerosis. (C) 2004 by the National Kidney Foundation, Inc.