Comparison of C - reactive protein and high-sensitivity c-reactive protein levels in patients on hemodialysis

Abstract EN

Chronic inflammation is highly prevalent in patients on hemodialysis (HD), as evidenced by increased levels of C-reactive protein (CRP).

We compared CRP to high-sensitivity C-reactive protein (hs-CRP) to determine whether it has any clinical implications and prognostic significance in terms of mortality.

CRP was measured using a standard immunoturbidometric assay on the COBAS® INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD.

CRP ( ≥ 6 mg / L) and hs-CRP ( ≥ 3 mg / L) levels were elevated in 30 % and 54 % of the patients, respectively.

A significant correlation was noted between hs-CRP and CRP levels (r = 0.98, P < 0.001).

Deming regression analysis showed that the slope was near one (r = 0.90 ; 0.83–0.94) and that the intercept was small.

Multivariate regression confirmed that age above 40 years (RR = 3.69, P = 0.027) and duration on HD greater than five years (RR = 3.71, P = 0.028) remained significant independent predictors of serum hs- CRP.

Thirteen patients died during follow-up (26 %).

Multivariate Cox regression demonstrated that hs-CRP (RR = 1.062, P = 0.03) and CRP levels (RR = 1.057, P = 0.009) and age (RR = 1.078, P = 0.001) were the most powerful predictors of mortality.

The CRP standard assay presents a reasonable alternative to the hs-CRP assay in patients on HD.

The advantages of the CRP standard assay are its online and real-time availability as well as lower costs, particularly in developing countries.