
Chronic inflammation is highly prevalent in patients on hemodialysis (HD), as evidenced by increased levels of C-reactive protein (CRP). We compared CRP to high-sensitivity C-reactive protein (hs-CRP) to determine whether it has any clinical implications and prognostic significance in terms of mortality. CRP was measured using a standard immunoturbidometric assay on the COBAS® INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD. CRP (≥6 mg/L) and hs-CRP (≥3 mg/L) levels were elevated in 30% and 54% of the patients, respectively. A significant correlation was noted between hs-CRP and CRP levels (r = 0.98, P <0.001). Deming regression analysis showed that the slope was near one (r = 0.90; 0.83-0.94) and that the intercept was small. Multivariate regression confirmed that age above 40 years (RR = 3.69, P = 0.027) and duration on HD greater than five years (RR = 3.71, P = 0.028) remained significant independent predictors of serum hs-CRP. Thirteen patients died during follow-up (26%). Multivariate Cox regression demonstrated that hs-CRP (RR = 1.062, P = 0.03) and CRP levels (RR = 1.057, P = 0.009) and age (RR = 1.078, P = 0.001) were the most powerful predictors of mortality. The CRP standard assay presents a reasonable alternative to the hs-CRP assay in patients on HD. The advantages of the CRP standard assay are its online and real-time availability as well as lower costs, particularly in developing countries.
Adult, Male, Time Factors, R, Kaplan-Meier Estimate, Middle Aged, Prognosis, Risk Assessment, C-Reactive Protein, Logistic Models, Nephelometry and Turbidimetry, Predictive Value of Tests, Renal Dialysis, Risk Factors, Multivariate Analysis, Medicine, Humans, Female, Kidney Diseases, Inflammation Mediators, Biomarkers, Proportional Hazards Models
Adult, Male, Time Factors, R, Kaplan-Meier Estimate, Middle Aged, Prognosis, Risk Assessment, C-Reactive Protein, Logistic Models, Nephelometry and Turbidimetry, Predictive Value of Tests, Renal Dialysis, Risk Factors, Multivariate Analysis, Medicine, Humans, Female, Kidney Diseases, Inflammation Mediators, Biomarkers, Proportional Hazards Models
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