In:
American Journal of Nephrology, S. Karger AG, Vol. 25, No. 3 ( 2005), p. 189-195
Abstract:
〈 i 〉 Background: 〈 /i 〉 C-reactive protein (CRP), which reflects chronic inflammation, is a strong predictor of cardiovascular mortality in hemodialysis patients. We investigated whether persistent elevation of CRP is associatedwith cardiac function and morphology in patients maintained on hemodialysis. 〈 i 〉 Methods: 〈 /i 〉 Predialysis high-sensitivity CRP (hs-CRP) was measured twice at an interval of 3 weeks in 52 stable hemodialysis patients, and echocardiographic studies were performed. 〈 i 〉 Results: 〈 /i 〉 25 patients showed persistent elevation of predialysis hs-CRP ( 〉 3 mg/l, high CRP group). Patients in the high CRP group had a lower dialysis dose (p 〈 0.01), higher troponin T (p 〈 0.01), and higher fibrinogen (p 〈 0.01). Echocardiographic studies showed that left atrial diameter (LA, p 〈 0.05), interventricular septal thickness (IVST, p 〈 0.05), left ventricular end-diastolic volume (LVEDV, p 〈 0.05), and left ventricular mass index (LVMI, p 〈 0.05) were higher in the high CRP group. However the ejection fraction (EF) was lower in the high CRP group (p 〈 0.05), which also contained more patients with low EF ( 〈 40%) (p 〈 0.01). There was no difference in diabetes mellitus, acute infection and type of vascular access between the groups. hs-CRP level was positively correlated with troponin T (r = 0.416, p 〈 0.01) and fibrinogen (r = 0.560, p 〈 0.001), and IVST with hs-CRP level (r = 0.291, p 〈 0.05), whereas the EF was negatively correlated with hs-CRP(r = –0.301, p 〈 0.05). In addition, the high CRP group correlated positively with IVST (r = 0.281, p 〈 0.05), LVEDV (r = 0.322, p 〈 0.05), and LVMI (r = 0.312, p 〈 0.05) and negatively with EF (r = –0.311, p 〈 0.05). On multivariate analysis, the high CRP group (β = –0.312, β = 0.238, and β = 0.318, respectively) was a significant predictor of EF (R = 0.62, p = 0.025), LVMI (R = 0.928, p = 0.02) and IVST (R = 0.64, p = 0.01). 〈 i 〉 Conclusions: 〈 /i 〉 Persistent elevation of CRP, which is an independent risk factor for EF, LVMI and IVST, may predict cardiac hypertrophy and dysfunction in patients maintained on hemodialysis.
Type of Medium:
Online Resource
ISSN:
0250-8095
,
1421-9670
Language:
English
Publisher:
S. Karger AG
Publication Date:
2005
detail.hit.zdb_id:
1468523-1
