title: Increased C-reactive protein following hemodialysis predicts cardiac hypertrophy in chronic hemodialysis patients.
abstract: BACKGROUND
  Chronic inflammation characterized by increased C-reactive protein (CRP) levels strongly predicts cardiovascular death in both nonrenal and renal patients. We investigated the role of hemodialysis-induced elevated CRP levels on cardiac hypertrophy in hemodialysis patients.
  
  
  METHODS
  We grouped 118 stable patients as responders and nonresponders according to the response of CRP (>4 mg/L) after a single hemodialysis session.
  
  
  RESULTS
  Predialysis CRP and interleukin-6 (IL-6) concentrations were significantly greater in responders compared with nonresponders (6.4 versus 2.0 mg/L and 8.7 versus 4.8 ng/L, respectively; P < 0.01). Postdialysis CRP concentrations in responders (8.8 mg/L; P < 0.05) and IL-6 concentrations in responders and nonresponders (10.0 versus 5.4 ng/L; P < 0.05) further increased. Intact parathyroid hormone, fibrinogen, total cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a) [Lp(a)] levels (P < 0.05), as well as interventricular septal thickness (IVST; P < 0.005), left ventricular posterior wall thickness (LVPWT; P < 0.05), and left ventricular mass index (LVMi; P < 0.05) were significantly greater in responders compared with nonresponders. Predialysis and postdialysis CRP levels correlated positively with Lp(a) (P < 0.01, P < 0,05, respectively), fibrinogen, and predialysis and postdialysis IL-6 levels (P < 0.001) and negatively with albumin level (P < 0.05, P < 0.01, respectively). LVMi, as well as IVST and LVPWT, correlated not only with predialysis and postdialysis CRP levels, but also IL-6 levels (P < 0.05). The interval changes in postdialysis to predialysis CRP levels correlated significantly with IVST, PWT (r = 0.500; r = 0.458; P < 0.001, respectively), and LVMi (r = 0.252; P < 0.05). On multivariate analysis, the responder was the only predictor of IVST, LVPWT, and LVMi (P < 0.001, P < 0.001, and P < 0.01, respectively).
  
  
  CONCLUSIONS
  Elevated CRP concentrations associated with hemodialysis may be useful for the prediction of proatherogenic reactivity and cardiac hypertrophy.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Young Shin
authors.initials: YS
authors.lastname: Shin
authors.forename: Chul Min
authors.initials: CM
authors.lastname: Kim
authors.forename: So Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Su Eun
authors.initials: SE
authors.lastname: Yu
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Eui Jin
authors.initials: EJ
authors.lastname: Choi
authors.forename: Yoon Sik
authors.initials: YS
authors.lastname: Chang
authors.forename: Byung Kee
authors.initials: BK
authors.lastname: Bang
mesh_terms: D000740:Anemia / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D006332:Cardiomegaly / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood; D017379:Hypertrophy, Left Ventricular / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D006435:Renal Dialysis / Q000379:methods*; D012307:Risk Factors; D012709:Serum Albumin
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D012709:Serum Albumin; D002097:C-Reactive Protein