Increasing high-sensitive C-reactive protein level predicts peritonitis risk in chronic peritoneal dialysis patients

BMC Nephrology

Jin-Bor Chen²  Jyh-Chang Hwang¹  Ben-Chung Cheng²  Shang-Chih Liao²  Yu-Jen Su² 

[1] Division of Nephrology, Chi-Mei Medical Center, 901 Zhonghua Rd., Tainan, Yongkang District 71010, Taiwan;Division of Nephrology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Rd, Kaohsiung, Niao Song District, Taiwan

关键词: Peritonitis;    Peritoneal dialysis;    High-sensitivity C-reactive protein;   

Others  :  1082854
DOI  :  10.1186/1471-2369-14-185

 received in 2013-06-24, accepted in 2013-08-28,  发布年份 2013

【 摘 要 】

Background

The aim of this study was to evaluate whether a high baseline level of high-sensitivity C-reactive protein (hs-CRP) or changes in the level predicts the risk of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD).

Methods

A prospective, cross-sectional, case–control study was conducted in a single hospital-based PD unit. A total of 327 patients were included in the study. Serum hs-CRP was measured annually for 2 years. Patients were divided into 4 groups according to the changes in annual hs-CRP levels (at baseline and at 1 year intervals): group 1 (from <5 mg/L to <5 mg/L, n = 171), group 2 (from <5 mg/L to ≥5 mg/L, n = 45), group 3 (from ≥5 mg/L to <5 mg/L, n = 45), and group 4 (from ≥5 mg/L to ≥5 mg/L, n = 80). Demographics, biochemistry results, PD adequacy indices, and peritonitis risk were compared between the groups.

Results

The initial serum albumin level was similar in the 4 groups (p = 0.12). There was a negative linear correlation between the serial albumin change (∆alb) and serial hs-CRP change (∆hs-CRP; r = −0.154, p = 0.005). The hazard ratio (HR) for peritonitis was significantly higher in group 2 (HR = 1, reference) than in group 4 (HR = 0.401, 95% CI 0.209 − 0.769). Group 2 had a greater serum albumin decline rate (∆alb: –3% ± 9%) and hs-CRP elevation rate (∆hs-CRP: 835% ± 1232%) compared to those for the other groups.

Conclusions

A progressive increase in the hs-CRP level was associated with a corresponding decline in the serum albumin level. Progressive rather than persistently high levels of serum hs-CRP predicted peritonitis risk in CAPD patients.

【 授权许可】

   
2013 Su et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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