C-reactive Protein Is a Strong Predictor of Mortality in Hemodialysis Patients

Rački, Sanjin; Zaputović, Luka; Mavrić, Žarko; Vujičić, Božidar; Dvornik, Štefica

doi:10.1080/08860220600683581

Cited by 39 publications

(35 citation statements)

References 30 publications

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“…These results fit with a number of studies that have shown that an elevated CRP will predict mortality from cardiovascular causes in patients with other diseases, such as diabetes or renal disease (Racki et al 2006). …”

Section: C-reactive Proteinsupporting

confidence: 74%

Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice?

Kristan

2013

Arch. Immunol. Ther. Exp.

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Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible; this airflow limitation is both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gasses. COPD is undoubtedly an umbrella term, and it seems unlikely that all patients with COPD have the same underlying disease processes; thus, there is a need for differential treatment of different subgroups. A potential solution is to find modifiable biomarkers that can assist in drug development and distinguish subgroups of COPD. With the exception of lung function tests, there are currently no well-validated biomarkers or surrogate endpoints that can be used to establish the efficacy of a drug for COPD. This article discusses biomarkers of inflammation (fibrinogen, C-reactive protein, pulmonary and activation-regulated chemokine/CC-chemokine ligand-18, serum surfactant protein D, interleukin (IL)-6, IL-8 and tumor necrosis factor a, complement factor C5a), angiogenesis factors as a part of the pathogenetic aspect in this disease (vascular endothelial growth factor, angiogenin, and IL-8), and matrix degradation biomarkers. Troponin and natriuretic peptides are presented as biomarkers of cardiac involvement in the light of COPD comorbidities. Trials based on research on known clinical variables such as FEV1, BODE, and 6MWT in combination with biomarkers from lung and blood specimens will probably clarify part of the prognosis and natural history of the disease. This will also represent an additional step in COPD phenotyping and new treatment possibilities.

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Section: C-reactive Proteinsupporting

confidence: 74%

Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice?

Kristan

2013

Arch. Immunol. Ther. Exp.

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“…18 Activated RAAS increased the inflammatory mediator that is an independent risk factor for CVD. [4][5][6] Activated RAAS directly increases proinflammatory gene expression and activates oxidative stress, leading to progressive inflammation of the vascular endothelium. 6 The elevated hs-CRP caused by persistent inflammation in uremic conditions has been shown to be an independent predictor of cardiovascular death in Aliskiren in hemodialysis patients Y Morishita et al HDD-CKD patients.…”

Section: Discussionmentioning

confidence: 99%

“…6 The elevated hs-CRP caused by persistent inflammation in uremic conditions has been shown to be an independent predictor of cardiovascular death in Aliskiren in hemodialysis patients Y Morishita et al HDD-CKD patients. 4,5 The d-ROM level represents the total level of peroxidized metabolites. d-ROM has been used to evaluate the oxidative status, and its significance as a clinical marker has been reported in various fields, including HDD-CKD patients.…”

Section: Discussionmentioning

confidence: 99%

“…3 Persistent inflammation in uremic conditions has been shown to be an independent predictor of CVD in HDD-CKD patients. 4,5 Activated RAAS also increased inflammatory mediators by directly increasing proinflammatory gene expression and by putting oxidative stress on vascular endothelium. 6 Therefore, the blockade of RAAS is important to control BP and suppress inflammation leading to CVD in HDD-CKD patients.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Aliskiren on blood pressure and the predictive biomarkers for cardiovascular disease in hemodialysis-dependent chronic kidney disease patients with hypertension

et al. 2010

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The renin-angiotensin-aldosterone system (RAAS) has pivotal roles in the pathogenesis of hypertension in hemodialysisdependent chronic kidney disease (HDD-CKD) patients. Activated RAAS also increases inflammatory mediators by directly increasing proinflammatory gene expression and by putting oxidative stress on the vascular endothelium. Both hypertension and inflammation are major risk factors for cardiovascular disease (CVD) in HDD-CKD patients. In this study, we assessed the efficacy of a direct renin inhibitor, aliskiren, on blood pressure (BP) and CVD predictive biomarkers, such as brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) and diacron-reactive oxygen metabolite (d-ROM). A total of 30 hypertensive HDD-CKD patients were assigned to receive aliskiren (150 mg) orally once daily with their existing antihypertensives. After 8 weeks, aliskiren treatments reduced systolic blood pressure (SBP) from 169.0 ± 20.1 to 153.7 ± 19.6 mm Hg (Po0.001) and diastolic blood pressure (DBP) from 78.1 ± 12.0 to 73.0 ± 13.6 mm Hg (P¼0.048). RAAS was suppressed by aliskiren treatment as follows: PRA (from 3.6±4.0 to 1.0±1.5 ng ml -1 h -1 (P¼0.004)), angiotensin I (from 1704.0 ± 2580.9 to 233.7 ± 181.0 pg ml -1 (P¼0.009)), angiotensin II (from 70.2 ± 121.5 to 12.4 ± 11.5 pg ml -1 (P¼0.022)) and aldosterone (from 107.9 ± 148.0 to 73.1 ± 34.6 pg ml -1 (NS)). The biomarkers for CVD were inhibited by aliskiren: BNP (from 362.5±262.1 to 300.0±232.0 pg ml -1 (P¼0.043)), hS-CRP (from 6.2±8.1 to 3.5±3.7 mg l -1 (P¼0.022)) and d-ROM (from 367.0 ± 89.8 to 328.3 ± 70.9 U.CARR (P¼0.022)). The inhibition levels of biomarkers for CVD by aliskiren did not correlate with the decreased levels of SBP and DBP. These results suggested that aliskiren was effective for BP control and may have cardiovascular protective effects in hypertensive HDD-CKD patients.

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“…[27][28][29][30][31] Poor outcomes have been associated with low albumin levels, elevated CRP or pro-inflammatory cytokine levels in ESRD patients; [32;33] collectively, elements of chronic inflammation and malnutrition appear to be among the strongest risk factors for high morbidity and mortality and low quality of life in CKD patients. [32] At present, most of the evidence implicating inflammation in adverse clinical outcomes in CKD is epidemiological, but the consistency of the studies is impressive.…”

Section: Inflammation and Outcomes In Ckdmentioning

confidence: 99%

Novel targets and new potential: developments in the treatment of inflammation in chronic kidney disease

Kövesdy

Kalantar-Zadeh

2008

Expert Opinion on Investigational Drugs

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Background-Patients with chronic kidney disease (CKD) of all stages experience extremely high mortality, with cardiovascular causes accounting for about half of all their deaths. Traditional risk factors such as hypertension, hypercholesterolemia and diabetes mellitus cannot explain the excessively high cardiovascular mortality in CKD. Chronic inflammation is one of the novel risk factors that appear to contribute to the increased mortality seen in patients with CKD. Therapeutic interventions targeting chronic inflammation in CKD may lead to improved outcomes.Objectives-To describe the role of inflammation in CKD and to review antiinflammatory pharmacologic therapies that could have a role in its therapy. Methods-Review of the literature and expert opinion.Results/Conclusion-Inflammation is a common and significant problem in CKD. There are currently no approved pharmacologic antiinflammatory therapies in CKD, but several agents are being studied in early clinical trials, while others could become viable alternatives in the future.

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C-reactive Protein Is a Strong Predictor of Mortality in Hemodialysis Patients

Abstract: Serum concentration of CRP above 6.2 mg/L is a strong predictor of overall and cardiovascular mortality in patients with ESRD.

Cited by 39 publications

References 30 publications

Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice?

Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice?

Effects of Aliskiren on blood pressure and the predictive biomarkers for cardiovascular disease in hemodialysis-dependent chronic kidney disease patients with hypertension

Novel targets and new potential: developments in the treatment of inflammation in chronic kidney disease

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