Association of Serum C-Reactive Protein (CRP) with Some Nutritional Parameters of Maintenance Hemodialysis Patients

Abstract

Malnutrition and inflammation are common in hemodialysis patients, and are usually closely associated. Serum C-reactive protein (CRP) concentrations have been found to be significantly elevated in hemodialysis patients and reflects chronic inflammation, and as an acute-phase reactant, is a sensitive and independent marker of malnutrition. To investigate the association of serum CRP level with some nutritional variables in diabetic and non diabetic end-stage renal failure patients undergoing regular hemodialysis, we designed a study of 36 maintenance hemodialysis patients (f = 15 m = 21), consisting of 25 non-diabetic HD patients and 11 diabetic HD patients. In this study we found a near significant difference of CRP between diabetic and non-diabetics of total patients with more values of CRP in diabetics, a significant difference of CRP between diabetic and non-diabetic of female HD patients with more values in diabetics and a significant difference of CRP between males and female of non-diabetic population with more values of CRP in males. An inverse correlation of serum CRP with serum cholesterol and triglyceride levels and a near significant positive correlations of CRP with serum ALP and with serum iPTH were found. An inverse correlation of serum CRP with dialysis efficacy was seen too. No significant association between serum CRP and serum albumin was seen. Compatible with some studies and in contrast to some other studies, the association of serum albumin with serum CRP levels in this study was insignificant. The positive correlation of high serum PTH with inflammation implies further need to control of hyperphosphatemia and secondary hyperparathyroidism in HD patients, also inverse correlation of serum CRP with cholesterol and triglyceride further support the malnutrition-inflammation complex syndrome (MICS) which frequently seen in HD patients.