The Hematocrit-Corrected Erythrocyte Sedimentation Rate Can Be Useful in Diagnosing Inflammation in Hemodialysis Patients

Abstract

Background/Aims: We aimed to determine predictors of erythrocyte sedimentation rate (ESR), and the ESR level pointing to the presence of inflammation in 60 chronic hemodialysis (HD) patients. Methods/Results: On bivariate analysis, increased Westergren ESR of 62 (4–160) mm/h correlated inversely with hematocrit (Hct) and serum albumin, and positively with age, plasma fibrinogen, serum C-reactive protein (CRP), immunoglobulins A and G, α₁-acid-glycoprotein and α₁-antitrypsin. On multivariable analysis, independent predictors of the ESR were raised CRP (p < 0.0001), low Hct (p < 0.0001), increased fibrinogen (p < 0.0001) and immunoglobulin A (p = 0.009), and older age (p = 0.015). The Hct-corrected ESR level [ESR × (Hct/45)] of 38 (4–91) mm/h was independently predicted by CRP (p < 0.0001), fibrinogen (p < 0.0001), and age (p = 0.001). In the patients with normal CRP and albumin, the Hct-corrected ESR value was normal (23 mm/h) and lower than that of 59 mm/h in the subjects with elevated CRP and hypoalbuminemia. Using these cut-off points, the positive and negative predictive values of the Hct-corrected ESR on the presence of inflammation were 1.0, and its sensitivity and specificity were 100%. Conclusion: Increased Westergren ESR in HD patients is associated with activated acute-phase response, anemia, and aging. The Hct-corrected ESR values of 23 and 59 mm/h precisely select the HD patients with severe inflammation from those without.

Rheumatoid peripheral blood phagocytes are primed for activation but have impaired Fc-mediated generation of reactive oxygen species

“…The most accepted inflammatory measurements used in clinical medicine are the erythrocyte sedimentation rate (ESR) and levels of C-polysaccharide reactive protein (C-reactive protein; CRP) [34]. ESR indirectly reflects potentially increasing serum proteins, such as fibrinogen, acute-phase proteins and immunoglobulins [35]. CRP is the most studied acute-phase protein and is a good measure of activity of disease because high circulating levels are correlated with the acute inflammatory stages of the disease, and low levels with quiescent stages [36].…”

Effect of Anti-HCV Positivity on Markers of Malnutrition and Inflammation in Hemodialysis Patients

“…However, corrected ESR levels according to hematocrit was reported to better serve to select the inflammationafflicted HD patients. [14] In this study, these markers, selected as the indices of inflammation, and MIS were not found to be different between HCV-infected and non-infected HD patients. Nascimento et al has also investigated the effect of hepatitis C on two markers of systemic inflammationm, and they also could not find any difference between IL-6 and CRP levels of anti-HCV-positive and -negative HD patients.…”

“…Hematocritcorrected ESR was calculated using the formula ESR × (Hct ÷ 45) after measuring ESR. [14] Blood urea nitrogen, creatinine, calcium, phosphorus ALT, AST, total iron binding capacity, and lipid profile were measured with routine laboratory techniques using an automated analyzer (RocheHitachi 912, Roche Hitachi Modular Analytics, Roche Mid-arm muscle circumference = Mid-arm circumference (3. − 1 1416 triceps skinfold thickness).…”

Aggressive Surgical Intervention in End-Stage Renal Disease Patients with Spinal Epidural Abscess

“…Increased ESR in HD patients may be associated with acute-phase response, anemia, and aging. 9 Image study was indicated for all patients in ESRD with neurologic deficit, severe focal back pain, or unexplained fever with raised ESR.…”