engleski

C-reactive protein is a strong predictor of overall and cardiovascular mortality in haemodialysis patients

To establish the baseline cut-off point of C-reactive protein (CRP) as a predictor for increased overall and cardiovascular mortality in end-stage renal disease (ESRD) patients. To assess the influence of CRP value above the cut-off point on the survival, we analysed a cohort of 270 prevalent haemodialysis patients at Rijeka University Hospital, Croatia. We completed three monthly consecutive measurements of CRP and only the patients with constant consecutive CRP values were included. 14 patients did not meet inclusion criteria. During the 24-month follow up, 24 patients were transplanted. The CRP cut-off point of 6.2 mg/L was established using Receiver Operating Characteristic (ROC) curve. Subsequently, the patients were assigned into four groups: group 1 (CRP <3 mg/L ; N=80 ; 34.5%), group 2 (CRP 3-6.1 mg/L ; N=23 ; 9.9%), group 3 (CRP 6.2-10 mg/L ; N=18 ; 7.7%), and group4 (CRP>10 mg/L ; N=111 ; 47.9%). An increased CRP value over the established cut-off value was found in 129(55.6%) patients. The survival was evaluated by Kaplan-Meier curve. During the follow-up 59 patients died. The major cause of death was cardiovascular disease (64%). Significantly higher overall and CV mortality was observed in group 3 compared with group 1 and 2 (p<0.001), and in group 4 compared with group 1 and 2 (p<0.001). Compared with survivors, non-survivors had a higher median level of CRP (19.0 mg/L vs. 2.3 mg/L ; p<0.001). Elevated CRP value over 6.2 mg/L is a strong predictor of overall and CV mortality in ESRD population.

C-reactive protein; predictor; mortality; haemodialysis; cardiovascular diseases; renal failure

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