Acute phase reactants in hemodialysis patients in relation to ejection fraction

Abstract

Chronic Kidney Disease (CKD) is considered a public health problem because of its high prevalence, morbidity and mortality. 1 Morbidity remains high with more than 20% of patients undergoing hemodialysis dying every year with frequent complications of heart disease, hypertension, anaemia, inflammation and physical function. 2 Coronary artery disease has accounted for 40-50% of deaths among patients who undergo dialysis. Myocardial infarction has approximately accounted for 10-20% of these deaths which occur shortly after initiating dialysis with 29% within 1 year and 52% within 2 years. The risk increases as the kidney function declines. The present study aims to study the serum levels of hs-CRP and ferritin in hemodialysis patients and to correlate with ejection fraction as an indirect association of coronary artery disease and therefore to study the role of inflammatory markers hs-CRP and ferritin in hemodialysis patients and their role as predictive markers in coronary artery disease. The study included 50 hemodialysis patients with CAD and 50 hemodialysis patients without CAD. hs-CRP and ferritin parameters were analysed. hs-CRP and ferritin levels were significantly increased in hemodialysis patients with CAD (p<0.000) and the ejection fraction in patients on hemodialysis with coronary artery disease was significantly low (p<0.000). From the above values we can infer that hemodialysis patients with CAD have less ejection fraction when compared to hemodialysis patients without CAD. In conclusion, there was a significant elevation in the hs-CRP and ferritin levels when compared to controls furthermore it was also associated with worse prognosis for cardiovascular diseases.