Comparison of C-reactive protein and high-sensitivity C-reactive protein levels in patients on hemodialysis

Saudi J Kidney Dis Transpl. 2012 May;23(3):477-83.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Female
  • Humans
  • Inflammation Mediators / blood*
  • Kaplan-Meier Estimate
  • Kidney Diseases / blood
  • Kidney Diseases / immunology
  • Kidney Diseases / mortality
  • Kidney Diseases / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nephelometry and Turbidimetry
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / mortality
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tunisia

Substances

  • Biomarkers
  • Inflammation Mediators
  • C-Reactive Protein