Correlation of High Sensitive C Reactive Protein Levels as Inflammation Marker with Red Blood Cell Distribution Width Value in Regular Hemodialysis Patients at H. Adam Malik General Hospital

Background: Chronic kidney disease (CKD) is characterized by structural and functional disorder of the kidney with irreversible and gradual characteristics with one of the modalities of renal replacement therapy such as hemodialysis (HD). The role of inflammation in HD patients by uremic toxin and dialysis can be assessed by the marker of High Sensitive C Reactive Protein (HsCRP). Several studies have examined the relationship between HsCRP and red cell distribution width (RDW) in regular HD patients which leads to increase patient morbidity and mortality, but until now, there has been no study in Indonesia regarding the correlation between HsCRP and RDW in regular HD patients. This study aims to determine the correlation HsCRP as a marker of inflammation and RDW values in regular HD patients. Methods: This is a cross-sectional study in Regular HD patients at Dialysis Unit-H. Adam Malik General Hospital. A total of 20 subjects were included. Bivariate and multivariate analysis was conducted to analyze the relationship of HsCRP, ureum, creatinin, hemoglobin, and eGFR to RDW. Results: There were 20 Regular HD patients analyzed. The proportion of patients with increased RDW was 80%. In pearson correlation test, there is a strong correlation between HsCRP and RDW (r= 0.667, p<0.001). Discussion: Majority of regular HD patients at H. Adam Malik General Hospital were assessed with increased RDW. Pearson correlation analysis revealed HsCRP was significantly associated with RDW. Conclusion: Increased RDW was found in 80% of regular HD patients at H. Adam malik General Hospital. From pearson correlation analysis, we found HsCRP was significantly associated with RDW. Keywords: inflammation, high sensitive c reactive protein, red blood cell distribution width, regular hemodialysis.

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Correlation of Albumin Serum Levels as Inflammation Marker with Red Blood Cell Distribution Width Value in Regular Hemodialysis Patients at H. Adam Malik General Hospital Medan

International Journal of Research and Review ◽

10.52403/ijrr.20210752 ◽

2021 ◽

Vol 8 (7) ◽

pp. 369-374

Author(s):

Soraya Mourina Hutasuhut ◽

Alwi Thamrin Nasution ◽

M. Feldy Gazaly Nasution

Keyword(s):

Blood Cell ◽

Serum Albumin ◽

General Hospital ◽

Red Blood Cell ◽

Serum Levels ◽

Cell Distribution ◽

Distribution Width ◽

The Mean ◽

Red Blood Cell Distribution ◽

Regular Hemodialysis

Background: One of the modalities of renal replacement therapy in chronic kidney disease (CKD) is hemodialysis (HD). The role of inflammation in HD patients by uremic toxins and dialysis can be assessed by the marker of serum albumin. This inflammation also causes dysregulation of the hormone erythropoietin which results in increased variability or heterogeneity of red blood cell distribution width (RDW). Previous studies have revealed an association between RDW and albumin levels in regular HD patients which leads to increased patient morbidity and mortality. This study aims to determine the relationship between albumin serum levels and RDW as a marker of inflammation in regular HD patients. Method: This was a cross sectional study design, conducted in June to August 2020 at the HD unit of Haji Adam Malik General Hospital in Medan. Twenty subjects were included. Data were analyzed using Pearson correlation test and T-test to find the correlation between albumin serum levels and RDW, and other variables. Results: Of the 20 subjects taken based on consecutive sampling, the majority was male, 13 people (65%), mean age was 50.30 ± 12.57 years with the most comorbid type 2 diabetes mellitus for 14 people (70%). The mean serum albumin level was 3.2 ± 0.65 mg/dl. The mean RDW value was 15.93 ± 1.87%. This study showed that there was a significant relationship between serum albumin levels and RDW values (r = - 0.687; p = 0.001). RDW values were also significantly associated with hemoglobin levels (r = 0.497; p = 0.026) and creatinine (r= 0.519; p= 0.019). Conclusion: Albumin, hemoglobin, and creatinine levels were significantly associated with RDW values in regular HD patients. Keywords: inflammation, albumin, regular hemodialysis, RDW.

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