Inflammation, Diabetes, and Chronic Kidney Disease: Role of Aerobic Capacity

The persistent inflammatory state is common in diabetes and chronic kidney disease (CKD). These patients present exercise intolerance and increased arterial stiffness. Long-term aerobic exercise has been associated with better arterial compliance, antidiabetic and antiinflammatory benefits. We assessed the hypothesis that in patients with diabetes and CKD, better aerobic capacity is associated with less inflammatory state and arterial stiffness. Thirty-nine CKD patients (17 in hemodialysis) were evaluated. According to CKD etiology two patient groups were obtained: group of diabetics (GD) was formed by 11 patients and nondiabetics (GND) formed by 28 patients. Central blood pressure and arterial stiffness were evaluated by Sphygmocor device. Carotida intima-media thickness (CA-IMT) was evaluated by ultrasonography. Aerobic capacity was measured by estimated VO2max according to treadmill test by Bruce protocol. The GD showed a higher frequency of C-reactive protein above laboratory cutoff (P=0.044), higher frequency of male gender, and a non significant higher value of VO2max (P=0.099). The CA-IMT was similar. Only better aerobic capacity was associated with lower frequency of high C-reactive protein when adjusted to diabetes and gender in a logistic regression model. In conclusion, aerobic capacity was associated with inflammatory state, in CKD patients, independently of diabetes presence.

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C-reactive Protein and Hepcidin in Non-Dialysis Chronic Kidney Disease

Indonesian Journal of Tropical and Infectious Disease ◽

10.20473/ijtid.v8i3.12226 ◽

2020 ◽

Vol 8 (3) ◽

pp. 161

Author(s):

Edward Muliawan Putera ◽

Widodo Widodo ◽

Nunuk Mardiana

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Diseases ◽

P Value ◽

C Reactive Protein ◽

Acute Phase Reactants ◽

Cross Sectional ◽

Protein Levels ◽

Reactive Protein ◽

Inflammatory State

Complications such as anemia and its clinical consequences arise as chronic kidney diseases progress,. One renal anemia pathophysiology is a disruption of iron metabolism, regulated by the main iron exporter hormone, hepcidin. Chronic kidney disease patients were constantly in an inflammatory state, represented by an increased in C-reactive protein. This inflammatory state would facilitate the liver to secrete hepcidin, which would subsequently follow a decrease of iron circulation, thus resulting in functional iron deficiency. Both acute phase reactants which used thoroughly as markers in tropical and infectious diseases, had their own roles in chronic kidney disease. The correlation of c-reactive protein and hepcidin in chronic kidney disease patients was still controversial. To analyse the relationship between c-reactive protein and hepcidin in non-dialysis chronic kidney disease patients. We conducted an observational cross-sectional study with 40 non-dialysis chronic kidney disease patients who met the inclusion and exclusion criteria. Patients were enrolled with consecutive sampling and were examined for serum c-reactive protein and hepcidin levels.A total of forty subjects (67.5% male with mean age of 50.23 ± 1.04 years) were eligible for enrolment in this study. The most comorbid factor was hypertension (62.5%). The common stage for chronic kidney disease was stage 3 (40%). The mean hemoglobin value was 10.74 ± 0.36 g/dL, mean blood urea nitrogen was 39.98 ± 29.59 mg/dL, and serum creatinine of 4.12 ± 3.39 mg/dL. Mean serum c-reactive protein levels were 3.52 ± 5.13 mg/l. Mean hepcidin level were 94,03 ± 95,39 ng/ml. Serum C-reactive protein levels correlated positively (r=0.487) and significantly (p-value=0.001) with serum hepcidin value. C-reactive protein and hepcidin was significantly correlated in non-dialysis chronic kidney disease patients.

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Metabolic Syndrome-Associated Risk Factors and High-Sensitivity C-Reactive Protein Independently Predict Arterial stiffness in 9903 Subjects With and Without Chronic Kidney Disease

Medicine ◽

10.1097/md.0000000000001419 ◽

2015 ◽

Vol 94 (36) ◽

pp. e1419 ◽

Cited By ~ 14

Author(s):

Sung-Sheng Tsai ◽

Yu-Sheng Lin ◽

Chia-Pin Lin ◽

Jawl-Shan Hwang ◽

Lung-Sheng Wu ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arterial Stiffness ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Associated Risk Factors

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Temporal evolution of C-reactive protein levels and its association with the incident hospitalization risk among individuals with stage 3–4 chronic kidney disease

International Urology and Nephrology ◽

10.1007/s11255-021-02935-2 ◽

2021 ◽

Author(s):

Koray Uludag ◽

Gulsah Boz ◽

Tamer Arikan ◽

Ali Ihsan Gunal

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Temporal Evolution ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein

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Combined body mass index with high-sensitivity C-reactive protein as independent predictors for chronic kidney disease in a relatively healthy population in Taiwan

European Journal of Clinical Nutrition ◽

10.1038/ejcn.2016.28 ◽

2016 ◽

Vol 70 (7) ◽

pp. 766-771 ◽

Cited By ~ 1

Author(s):

Y-W Tsai ◽

M-C Lu ◽

Y-H Lin ◽

Y-C Lee ◽

W-C Li ◽

...

Keyword(s):

Body Mass Index ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Body Mass ◽

High Sensitivity ◽

Healthy Population ◽

C Reactive Protein ◽

Reactive Protein

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1856 ASSOCIATION OF RISE IN C-REACTIVE PROTEIN WITH DE NOVO CHRONIC KIDNEY DISEASE AFTER PARTIAL NEPHRECTOMY

The Journal of Urology ◽

10.1016/j.juro.2012.02.1966 ◽

2012 ◽

Vol 187 (4S) ◽

Author(s):

Seth A. Cohen ◽

Kerrin L. Palazzi ◽

Ryan P. Kopp ◽

Reza Mehrazin ◽

Samuel K. Park ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Partial Nephrectomy ◽

De Novo ◽

C Reactive Protein ◽

Reactive Protein

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Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder

Galen Medical Journal ◽

10.31661/gmj.v10i0.1512 ◽

2021 ◽

Vol 10 ◽

pp. e1512

Author(s):

Parichehr Alizadeh ◽

Ehsan Bahramali ◽

Arvin Hedayati ◽

Azizallah Dehghan

Keyword(s):

Myocardial Infarction ◽

High Sensitivity ◽

Intima Media Thickness ◽

Public Health Issue ◽

C Reactive Protein ◽

Mild Depression ◽

Reactive Protein ◽

Depressed Patients ◽

Inflammatory State ◽

Hs Crp

Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusions: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512]

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MO609PREVALENCE OF MALNUTRITION AND INFLAMMATION IN NONDIALYZED PATIENTS WITH CHRONIC KIDNEY DISEASE: A CLINICAL STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab089.0022 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Manzoor Parry ◽

Hamad Jeelani

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Serum Albumin ◽

Serum Ferritin ◽

Chronic Glomerulonephritis ◽

C Reactive Protein ◽

Reactive Protein ◽

North East ◽

Inflammatory Status ◽

Initiation Of Dialysis

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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