hsCRP and all cause mortality in hemodialysed patients

Ruskovska, Tatjana (2011) hsCRP and all cause mortality in hemodialysed patients. Review of Global Medicine and Healthcare Research (RGMHR), 2 (1). pp. 72-78. ISSN 1986-5872

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Abstract

INTRODUCTION: High sensitivity CRP (hsCRP) has been used as a marker of low intensity chronic inflammation in many different pathologic conditions.
AIM OF THE STUDY: The aim of this study was to elucidate the value of hsCPR as a marker of one year and two years all cause mortality in patients on chronic hemodialysis treatment.
PATIENTS, METHODS AND STUDY DESIGN: All 60 patients (31 men and 29 women) from Department of Hemodialysis were included in study. Four consecutive measurements of serum hsCRP were done: at the beginning of the study, after two weeks, 6 and 9 months. Immunoturbidimetric method on Olympus (now Beckman Coulter) AU400 automated biochemistry analyzer was used.
The lowest of four hsCRP values was considered as the “basal hsCRP value” for any individual patient.
Based on their basal hsCRP values all patients were divided in three groups:
1. basal hsCRP value up to 1 mg/L (n = 26, 8 men and 18 women; age = 57±12 years; duration of hemodialysis = 8±7 years);
2. basal hsCRP value from 1 to 3 mg/L (n = 18, 12 men and 6 women; age = 62±10 years; duration of hemodialysis = 7±6 years);
3. basal hsCRP value above 3 mg/L (n = 16, 11 men and 5 women; age = 66±9 years; duration of hemodialysis = 9±7 years).
The all cause mortality rate was calculated after one and two years since the last hsCRP measurement.
Student’s t-test, Chi-Square test and Fisher’s exact test were used for statistical calculations, as appropriate.
RESULTS: There was no statistically significant difference in the duration of hemodialysis between all three groups (p>0,05).
There was no statistically significant difference in the age between the first and second group as well as the second and third group. Patients from the first group were significantly younger than those from the third group (p<0,025) therefore these two groups were not compared.
One year after the last hsCRP measurement, the mortality rates were: 3,8% for the first group, 5,6% for the second group and 37,5% for the third group.
There was no statistically significant difference in the mortality rate between first and second group one year after the last hsCRP measurement. At the same time, the difference in the mortality rate between the second and third group was statistically significant (p<0,025).
Two years after the last hsCRP measurement the mortality rates were: 3,8% for the first group, 27,8% for the second group and 37,5% for the third group.
Statistically, there was no significant difference in the mortality rate between the second and third group. However, the difference between the first and second group was statistically significant (p<0,025).
Almost all patients that died during the study period were older than 60 years.
CONCLUSION: High hsCRP values, above 3mg/L, could be considered as a marker for prediction of one year all cause mortality among elderly patients on chronic hemodialysis treatment, while values between 1 and 3mg/L have a higher association with two years all cause mortality when the age of the patients and duration of hemodialysis were standardized.
Very low mortality rate within the two years study period among patients with basal hsCRP lower than 1mg/L confirms that these are “safe hsCRP values” associated with very low risk of all cause mortality independently of age, duration of hemodialysis and comorbidities.

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Tatjana Ruskovska
Date Deposited:	24 Nov 2012 08:59
Last Modified:	24 Nov 2012 08:59
URI:	https://eprints.ugd.edu.mk/id/eprint/1890

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