Significance of high C-reactive protein levels in pre-dialysis patients

Ortega, Olimpia; Rodríguez, Isabel; Gallar, Paloma; Carreño, Agustín; Ortiz, Milagros; Espejo, Beatriz; Jimenez, J; Gutierrez, Magdalena; Oliet, Aniana; Vigil, Ana

doi:10.1093/ndt/17.6.1105

Cited by 81 publications

(80 citation statements)

References 20 publications

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“…Probably, inflammation could be related to some factors, frequently associated with renal failure, which can worsen with the worsening of renal function. In this study (Ortega et al, 2002), CRP levels were higher in those patients with a previous history of CVD. Comparing with patients with normal CRP levels at baseline, patients with higher levels maintained significant higher levels on follow-up.…”

Section: Possible Causes Of Inflammationsupporting

confidence: 44%

“…Another possibility could be that uremia by itself could be the cause of inflammation among these patients. However, in another study performed in pre-dialysis patients with a more homogeneous clearance of creatinine (Ortega et al, 2002), a non-normal distribution of CRP levels were detected. That means that only a group of patients with advanced renal failure shows high levels of CRP, whereas other patients with the same degree of renal insufficiency have even normal CRP values.…”

Section: Possible Causes Of Inflammationmentioning

confidence: 87%

“…Activation of monocytes with the subsequent enhanced release of inflammatory cytokines can be caused by membrane-induced complement activation, by direct cell-membrane interaction and by dialysis fluids containing endotoxins (Carracedo et al, 2006;Honkanen et al, 1991;Kerr et al, 2007;Schouten et al 2000). However, a similar prevalence of inflammation has been described in patients with advanced renal failure not yet on dialysis (Ortega et al, 2002;Panichi et al, 2002;Stenvinkel et al, 1999). An inverse correlation between CRP levels and clearance of creatinine has been observed (Panichi et al, 2002); thus, CRP levels increase as renal function declines.…”

Section: Possible Causes Of Inflammationmentioning

confidence: 99%

See 2 more Smart Citations

Biomarkers in Chronic Kidney Disease - The Linkage Between Inflammation, Ventricular Dysfunction and Overhydration

Ortega¹

2011

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

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Section: Possible Causes Of Inflammationsupporting

confidence: 44%

Section: Possible Causes Of Inflammationmentioning

confidence: 87%

Section: Possible Causes Of Inflammationmentioning

confidence: 99%

See 1 more Smart Citation

Biomarkers in Chronic Kidney Disease - The Linkage Between Inflammation, Ventricular Dysfunction and Overhydration

Ortega¹

2011

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

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“…Inflammation is a highly prevalent condition among CKD patients. Crosssectional studies have shown that 30-50% of nondialysis (Ortega et al, 2002) and dialysis (Docci et al, 1990;McIntyre et al, 1997) patients present serologic evidence of an activated inflammatory response with elevated serum concentration of C-reactive protein (CRP). Our group has recently reported increased REE in nondialysis patients with CRP40.5 mg/dl (Avesani et al, 2004a).…”

Section: Introductionmentioning

confidence: 99%

Resting energy expenditure and its determinants in hemodialysis patients

et al. 2006

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Objective: Chronic kidney disease is associated with several metabolic disturbances that can affect energy metabolism. As resting energy expenditure (REE) is scarcely investigated in patients on hemodialysis (HD) therapy, we aimed to evaluate the REE and its determinants in HD patients. Design: Cross-sectional study. Setting: Dialysis Unit of the Nephrology Division, Federal University of São Paulo, Brazil. Subjects: The study included 55 patients (28 male, 41.4712.6 years old) undergoing HD therapy thrice weekly for at least 2 months, and 55 healthy individuals pair matched for age and gender. Subjects underwent fasting blood tests, as well as nutritional assessment, and the REE was assessed by indirect calorimetry. Results: REE of HD patients was similar to that of pair-matched controls (13797272 and 14407259 kcal/day, respectively), even when adjusted for fat-free mass (P ¼ 0.24). REE of HD patients correlated positively with fat-free mass (r ¼ 0.74; Po0.001) and body mass index (r ¼ 0.37; Po0.01), and negatively with dialysis adequacy (r ¼ À0.46; Po0.001). No significant univariate correlation was found between REE and age, dialysis vintage, serum creatinine, urea, albumin, bicarbonate, parathyroid hormone (PTH) or high-sensitivity C-reactive protein (CRP). In the multiple linear regression analysis, using REE as dependent variable, the final model showed that besides the well-recognized determinants of REE such as fat-free mass and age, PTH and CRP were the independent determinants of REE in HD patients (R 2 ¼ 0.64).

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“…12 Hypo-albuminemia is highly predictive of future mortality risk when present at the time of initiation of chronic dialysis, as well as during the course of maintenance dialysis (MD). [13][14][15][16] It is considered that a decreased albumin level at the pre-dialysis stage with early CKD will translate into high malnutrition levels at the time these patients would require RRT.…”

mentioning

confidence: 99%

C - reactive protein predictive marker value and its significance in management of pre dialysis chronic kidney disease patients when correlated with total serum proteins and serum albumin levels: experience in a teaching institution

et al. 2017

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Background: Chronic kidney disease (CKD) is imposing newer challenges, not only globally, but, also in India, especially managing the end stage renal disease (ESRD). Screening for CKD at an early stage, by, high sensitivity C reactive protein (hsCRP) with or without other clinical, biochemical or anthropometric parameters helps initiate specific therapy to reduce the progression of renal disease. Although, malnutrition, inflammation and cardio vascular diseases (CVD) have been shown as significant independent risk factors of mortality in CKD patients, but, whether there exists any relationship between hsCRP and serum proteins and serum albumin levels, one of the important indicators of PEM, has not been extensively studied in pre-dialysis CKD patients.Methods: The study included a total of 60 adult subjects. Of these, 30 were study cases who fulfilled the case definition of CKD and were compared with 30 patients who did not show any signs or symptoms of CKD. As per the objective - hsCRP values were estimated by ELISA test, quantified and statistically correlated with total serum proteins and albumin levels.Results: A significant difference was found in the mean value of hsCRP in cases and in controls (p value 0.001). No significant difference was observed in the mean level of total serum protein in cases and controls, but, the mean differences in the level of serum albumin between cases and controls was significant. The association of serum albumin and hsCRP was found to be significant (p value <0.001). If a level of serum albumin < 3.5 is taken as a marker of malnutrition, it is found that 66.66% of patients have hypo-albuminaemia.Conclusions: The present study comes to an important conclusion that hsCRP is a useful independent predictor of CKD and if correlated with serum albumin levels, it would help clinician manage the patient effectively by initiating an aggressive yet very appropriate therapy at the pre-dialysis stage with the likelihood of an ‘evidence based’ reduction in morbidity and mortality.

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Significance of high C-reactive protein levels in pre-dialysis patients

Cited by 81 publications

References 20 publications

Biomarkers in Chronic Kidney Disease - The Linkage Between Inflammation, Ventricular Dysfunction and Overhydration

Biomarkers in Chronic Kidney Disease - The Linkage Between Inflammation, Ventricular Dysfunction and Overhydration

Resting energy expenditure and its determinants in hemodialysis patients

C - reactive protein predictive marker value and its significance in management of pre dialysis chronic kidney disease patients when correlated with total serum proteins and serum albumin levels: experience in a teaching institution

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