FP463ALBUMIN/C-REACTIVE PROTEIN RATIO IN THE TREATMENT OF PATIENTS WITH CHRONIC KIDNEY DISEASE - HIGH FLUX HEMODIALYSIS VS. ONLINE HEMODIAFILTRATION

Abstract Background and Aims The prevalence of chronic kidney disease (CKD) in India varies from 0.16–0.78%. The reported incidence of malnutrition in CKD patients is 37–84%. There is a paucity of data on the quantification of malnutrition and inflammation in undialyzed patients of CKD from north east of India. This study analyzed the prevalence and causes of malnutrition and inflammation in patients with CKD before the initiation of dialysis treatment. Method This study was conducted from May 2017 to May 2019 in the department of nephrology Guahati medical college hospital. Assessment of nutritional and inflammatory status was carried out in patients with CKD before initiation of dialysis. Serum albumin; body mass index (BMI); triceps skin fold thickness (TST); mid-arm muscle circumference (MAMC); and subjective global assessment (SGA) scoring were used for assessment of nutritional parameters. Serum C-reactive protein; serum albumin and serum ferritin level were used to assess the inflammatory status in these patients. Results A total of 528 (male:female= 359:169) patients with CKD participated in this study. Diabetic Nephropathy (35%) was the most common; followed by; hypertension (23%) and chronic glomerulonephritis (20 %). The evidence of malnutrition was noted in 344 (65%). The mean age of patients with malnutrition was 52.8±12.45 years with a male predominance (68%). On the basis of SGA score; malnutrition was noted in 344 patients (mild moderate [36%]; severe; [30%]); remaining (34%) were well nourished. Thus; evidence of Malnutrition was noted in 65% of patients with CKD.). Serum total protein & albumin were higher in the non-malnourished patients in comparison to malnourished (5.83±1.0 vs 5.31±1.12 p<0.05; 3.65±0.7 vs 2.62±0.74) The inflammatory markers (serum ferritin & C reactive protein) were elevated significantly in patients with malnutrition in comparison to those without malnutrition (308.15±60.18 mg/dL vs. 251.64±63.14 mg/dL; p < 0.001; 77% vs. 50%; p < 0.01). Conclusion Malnutrition and inflammation are common in patients with CKD before the commencement of dialysis. This indicates that an emphasis should be placed on the assessment and prevention or correction of malnutrition and inflammatory burden in these patients with CKD.

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P0926ASSOCIATION OF HIGH-SENSITIVE C-REACTIVE PROTEIN WITH CARDIOVASCULAR EVENTS, MORTALITY, AND ADVERSE KIDNEY OUTCOMES IN KOREAN PATIENTS WITH CHRONIC KIDNEY DISEASE: RESULTS FROM KNOW-CKD

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0926 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Changhyun Lee ◽

Keun Hyung Park ◽

Young Su Joo ◽

Ki Heon Nam ◽

Tae-Ik Chang ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular Events ◽

Primary Outcome ◽

Prediction Models ◽

Predictive Performance ◽

C Reactive Protein ◽

Reactive Protein ◽

The Mean ◽

Hs Crp

Abstract Background and Aims High-sensitivity C-reactive protein (hs-CRP) level is lower in East Asians than in the Western people and its clinical significance needs to be further explored. We aimed to investigate whether hs-CRP could function as a biomarker in Korean CKD patients. Method We studied the association of hs-CRP with adverse clinical outcomes in 2,018 patients from the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). The primary outcome was a composite of extended major cardiovascular events (MACE) or all-cause mortality. Extended MACE (eMACE) included non-fatal cardiovascular events, symptomatic arrhythmia, and cardiac death. The secondary endpoints were separate outcome of eMACE, all-cause death, and adverse kidney outcome. We also evaluated predictive ability of hs-CRP for the primary outcome. Results The median hs-CRP level was 0.60 mg/L (IQR 0.2-1.7), and the mean eGFR was 53.6 ml/min/1.73 m2. During the mean follow-up of 3.9 years, there were 125 (6.2%) eMACEs and 80 (4.0%) deaths. The primary composite outcome occurred more frequently in patients with higher hs-CRP level than in those with lower hs-CRP level. In multivariable Cox analysis after adjustment of confounders, there was a graded association of hs-CRP with the primary outcome. The HRs (95% CI) for hs-CRP of 1.0 to 2.99, and ≥ 3.0 mg/L were 1.37 (0.89-2.12) and 2.20 (1.36-3.56), compared with hs-CRP of <1.0 mg/L. In analyses of secondary outcomes, this association was consistent for eMACE and all-cause death; however, hs-CRP was not associated with adverse kidney outcomes. Finally, prediction models failed to show improvement of predictive performance of hs-CRP compared to conventional factors. Conclusion In Korean CKD patients, serum hs-CRP level was low and significantly associated with higher risk of eMACEs and mortality. However, a low serum hs-CRP level was not predictive of adverse kidney outcome, and the predictive performance of hs-CRP was not strong.

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Increased Risk of Chronic Kidney Disease in Elderly with Metabolic Syndrome and High Levels of C-Reactive Protein: Kahrizak Elderly Study

Kidney & Blood Pressure Research ◽

10.1159/000274046 ◽

2009 ◽

Vol 32 (6) ◽

pp. 457-463 ◽

Cited By ~ 18

Author(s):

Hossein Fakhrzadeh ◽

Maryam Ghaderpanahi ◽

Farshad Sharifi ◽

Zohre Badamchizade ◽

Mojde Mirarefin ◽

...

Keyword(s):

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

C Reactive Protein ◽

Reactive Protein ◽

Increased Risk

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C-reactive protein and low albumin are predictors of morbidity and cardiovascular events in chronic kidney disease (CKD) 3-5 patients

Clinical Nephrology ◽

10.5414/cnp67352 ◽

2007 ◽

Vol 67 (06) ◽

pp. 352-357 ◽

Cited By ~ 46

Author(s):

S. Soriano ◽

L. González ◽

A. Martín-Malo ◽

M. Rodríguez ◽

P. Aljama

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular Events ◽

C Reactive Protein ◽

Reactive Protein

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Do levels of C-reactive protein and blood protein spectrum components influence the clinical course of chronic heart failure combined with chronic kidney disease?

Russian Heart Failure Journal ◽

10.18087/rhfj.2016.2.2186 ◽

2016 ◽

Vol 17 (2) ◽

pp. 75-81

Author(s):

A.A. Nasybullina ◽

◽

O.V. Bulashova ◽

E.V. Khazova ◽

V.M. Gazizyanova ◽

...

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Chronic Heart Failure ◽

Kidney Disease ◽

Clinical Course ◽

Blood Protein ◽

C Reactive Protein ◽

Reactive Protein ◽

Protein Spectrum

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High-sensitivity C-reactive protein, apolipoproteins, and residual diuresis in chronic kidney disease patients undergoing hemodialysis

Clinical and Experimental Nephrology ◽

10.1007/s10157-016-1230-7 ◽

2016 ◽

Vol 20 (6) ◽

pp. 943-950 ◽

Cited By ~ 2

Author(s):

Daniela Lemos Borges ◽

Helton Pereira Lemes ◽

Valéria de Castro Ferreira ◽

Sebastião Rodrigues Ferreira Filho

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Residual Diuresis

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Impact of Chronic Kidney Disease on Cardiovascular and Renal Events in Patients Undergoing Percutaneous Coronary Intervention with Everolimus-Eluting Stent: Risk Stratification with C-Reactive Protein

Cardiorenal Medicine ◽

10.1159/000486971 ◽

2018 ◽

Vol 8 (2) ◽

pp. 151-159 ◽

Cited By ~ 4

Author(s):

Kazuhiro Dan ◽

Toru Miyoshi ◽

Makoto Nakahama ◽

Tomofumi Mizuno ◽

Kenzo Kagawa ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Kidney Disease ◽

Coronary Angiography ◽

Confidence Interval ◽

Coronary Intervention ◽

C Reactive Protein ◽

Reactive Protein ◽

Percutaneous Coronary

Background: Chronic kidney disease (CKD) and inflammation play critical roles in atherosclerosis. There is limited evidence regarding the relationship between CKD and patients receiving second-generation drug-eluting stents for coronary artery disease. Objective: This study aimed to investigate the effect of CKD on cardiovascular and renal events in patients undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES). Methods: We analyzed 504 consecutive patients with stable angina pectoris and significant coronary artery stenosis treated with EES. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 before coronary angiography. The primary outcome was the occurrence of major adverse renal and cardiovascular events (MARCE) including cardiac death, revascularization, heart failure, cerebral infarction, worsening renal function > 25% from baseline, and renal replacement therapy at 1 year. Results: Patients were divided into the a MARCE (n = 126) and a non-MARCE (n = 378) group. The incidence of CKD was 51% in all subjects (including those on hemodialysis) and was significantly higher in the MARCE group than in the non-MARCE group (p = 0.00001). Multivariate logistic regression analysis identified that CKD was independently associated with MARCE (adjusted odds ratio 2.03, 95% confidence interval 1.21–3.39, p = 0.007). Patients were divided into four groups based on CKD and C-reactive protein (CRP) level prior to initial coronary angiography. Cox proportional hazards analysis revealed that patients with CKD and high CRP (≥0.3 mg/dL) had the worst prognosis (hazard ratio 4.371, 95% confidence interval 2.634–7.252, p = 0.00001) compared to patients without CKD and with low CRP. Conclusion: CKD combined with CRP predicted more clinical events in patients undergoing PCI with EES.

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