scholarly journals Low High‐Sensitivity C‐Reactive Protein Level in Korean Patients With Chronic Kidney Disease and Its Predictive Significance for Cardiovascular Events, Mortality, and Adverse Kidney Outcomes: Results From KNOW‐CKD

2020 ◽  
Vol 9 (21) ◽  
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 ◽  
High Sensitivity ◽  
Predictive Performance ◽  
C Reactive Protein ◽  
Korean Patients ◽  
Reactive Protein ◽  
Hs Crp

Background Inflammation levels are lower in East Asians than in Western people. We studied the association between high‐sensitivity hs‐CRP (C‐reactive protein) and adverse outcomes in Korean patients with chronic kidney disease. Methods and Results We included 2018 participants from the KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) between April 2011 and February 2016. The primary outcome was a composite of extended major cardiovascular events (eMACE) or all‐cause mortality. The secondary end points were separate outcomes of eMACE, all‐cause death, and adverse kidney outcome. We also evaluated predictive ability of hs‐CRP for the primary outcome. The median hs‐CRP level was 0.60 mg/L. During the mean follow‐up of 3.9 years, there were 125 (6.2%) eMACEs and 80 (4.0%) deaths. In multivariable Cox analysis after adjustment of confounders, there was a graded association of hs‐CRP with the primary outcome. The hazard ratios for hs‐CRPs of 1.0 to 2.99 and ≥3.0 mg/L were 1.33 (95% CI, 0.87–2.03) and 2.08 (95% CI, 1.30–3.33) compared with the hs‐CRP of <1.0 mg/L. In 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 with conventional factors. Conclusions In Korean patients with chronic kidney disease, the hs‐CRP level was low and significantly associated with higher risks of eMACEs and mortality. However, hs‐CRP did not associate with adverse kidney outcome, and the predictive performance of hs‐CRP was not strong. Registration URL: http://www.clinicaltrials.gov ; Unique identifier: NCT01630486.

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

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 &lt;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.

scholarly journals High-sensitivity C-reactive Protein as a Marker of Future Cardiovascular Events in Chronic Kidney Disease Stage-5 Patients

2020 ◽  
Author(s):  
Nisha Abraham ◽  
C Beena ◽  
Sangeetha Merrin Varghese
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Ckd Stage ◽  
Hs Crp ◽  
Esrd Patients

Introduction: Chronic Kidney Disease (CKD) has been recognised as a worldwide health threat and understanding its complex patho-physiological mechanisms could go a long way in taking care of patients with CKD. One of the most important causes for mortality in End Stage Renal Disease (ESRD) patients is Cardiovascular Disease (CVD). ESRD is a low grade chronic inflammatory state, suspected to promote atherosclerosis. Aim: To determine, if there is any association between elevated High-sensitivity C-Reactive Protein (hs-CRP) and development of future cardiovascular events in stage-5 CKD patients. Materials and Methods: Forty-five CKD stage-5 patients were included in the study, after ruling out patients with established CVD. According to categorisation proposed by the American Heart Association for the cut-off value of hs-CRP-value (3 mg/L), patients were divided into two groups. Those who had hs-CRP more than 3 mg/L were considered to have ‘elevated hs-CRP’ and those who had a value 3 mg/L and below were considered to have ‘normal hs-CRP’ levels. These patients were followed-up monthly, for a period of one year to record any occurrence of cardiovascular events (coronary events/cerebrovascular accidents/peripheral occlusive vascular disease). Statistical Package for the Social Sciences (SPSS) 16.0 was used for analysis. Chi-square test and Mann-Whitney U-test were used for statistical comparison between the groups and a p-value of 0.05 or less was considered to be statistically significant. Receiver Operating Characteristic (ROC) curve was also plotted to determine the cut-off value for hs-CRP based on the occurrence of any cardiovascular event. Results: Baseline hs-CRP level was more than 3 mg/L in 42% of patients. Among those who had elevated hs-CRP, 78.9% of patients developed cardiovascular events during the follow-up period. This signifies a strong association between elevated hs-CRP and CVD in ESRD patients. The hs-CRP cut-off point of 3 mg/L was obtained from ROC curve. Conclusion: There was a significant association between elevated hs-CRP and development of cardiovascular events in ESRD patients. Hence, hs-CRP can be used as a marker of future cardiovascular events in CKD stage-5 patients.

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

2007 ◽  
Vol 67 (06) ◽  
pp. 352-357 ◽  
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

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

2016 ◽  
Vol 20 (6) ◽  
pp. 943-950 ◽  
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

On-admission Serum High-Sensitivity C-Reactive Protein Level Independently Predicts In-Hospital Mortality and Adverse Cardiovascular Events in ST-elevation Acute Myocardial Infarction

2021 ◽  
pp. 263246362110553
Author(s):  
Anggoro Budi Hartopo ◽  
Indah Sukmasari ◽  
Maria Patricia Inggriani ◽  
Thomas Rikl ◽  
Stefi Geovani Valentin Hayon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Events ◽  
Multivariable Analysis ◽  
High Sensitivity ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
St Elevation ◽  
Hs Crp ◽  
Elevation Acute Myocardial Infarction

Background: Inflammatory biomarkers are associated with adverse cardiovascular events during ST-elevation acute myocardial infarction (STEMI). We aimed to investigate the role of inflammatory biomarkers, high-sensitivity C-reactive protein (hs-CRP), and soluble ST-2 (sST2), for prediction of adverse cardiovascular events in STEMI. Methods: This was a prospective cohort study that consecutively enrolled patients with STEMI. Subjects were observed during hospitalization until discharge or fatal events happened. Adverse cardiovascular event was a compilation of cardiac mortality, acute heart failure, cardiogenic shock, reinfarction, and malignant ventricular arrhythmia. Blood samples were withdrawn on admission and inflammatory biomarkers (hs-CRP and sST2) were measured. The receiver operator characteristics curve and multivariable analysis were performed to determine which inflammatory biomarkers predict in-hospital adverse cardiovascular events and mortality. Result: Of 166 subjects, the in-hospital adverse cardiovascular events occurred in 41 subjects (24.6%) and mortality occurred in 16 subjects (9.6%). Subjects with in-hospital adverse cardiovascular events and mortality had a significantly higher hs-CRP level, but comparable sST2 level than subjects without events. The hs-CRP level was the most precise biomarkers to predict in-hospital adverse cardiovascular events (hs-CRP cut-off ≥2.75 mg/L) and mortality (hs-CRP cut-off ≥7 mg/L). Multivariable analysis indicated hs-CRP ≥2.75 mg/L as an independent predictor for in-hospital adverse cardiovascular events (adjusted odds ratio [OR]: 2.79, 95% confidence interval [CI]: 1.05-7.39, P = .039) and hs-CRP ≥7 mg/L for mortality (adjusted OR: 5.45, 95% CI: 1.13-26.18, P = .034) in STEMI. Conclusion: On admission, hs-CRP level independently predicted in-hospital adverse cardiovascular events, at cut-off level ≥2.75 mg/L, and mortality, at cut-off level ≥7 mg/L, in STEMI patients.

scholarly journals High Sensitivity C-Reactive Protein does not Correlate with IL-6 in Patients with Chronic Kidney Disease

2015 ◽  
Vol 13 (2) ◽  
pp. 100-101
Author(s):  
Neha Garg ◽  
Mrinalini Kotru ◽  
Anil Yadav ◽  
Meera Sikka ◽  
Om Parkash Kalra
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein
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