High-sensitivity C-reactive protein level is a significant risk factor for silent cerebral infarction in patients on hemodialysis.
In patients with chronic renal failure on hemodialysis (HD), silent cerebral infarctions (SCIs) are associated with high mortality. The levels of high-sensitivity C-reactive protein (HSCRP), a marker of inflammation and atherosclerosis, elevate with increasing renal dysfunction. We tested the hypothesis that increased HSCRP levels correlate with the occurrence of SCI in HD patients. By brain magnetic resonance imaging findings, we divided 54 patients undergoing HD into a with-SCI group (61 +/- 8 years, n = 30) and a without-SCI group (60 +/- 7 years, n = 24). We compared sex, body mass index, metabolic profiles, HSCRP levels, and smoking habits in Japanese patients on HD with and without SCI. We made the following observations: (1) The number of patients with diabetes or hypertension did not differ between the 2 groups. (2) The levels of HSCRP were higher in the with-SCI group in comparison with the without-SCI group (P < .0001). (3) The proportion of smokers was higher in the with-SCI group than in the without-SCI group (P < .05). (4) Plasma levels of high-density lipoprotein cholesterol were lower, whereas uric acid was higher, in the with-SCI group than in the without-SCI group (P < .05 and P < .0001, respectively). (5) Multivariate logistic analysis identified HSCRP levels as being significantly associated with the presence of SCI (odds ratio, 1.61; 95% confidence interval, 1.17-2.85; P < .001). This study indicates that patients in chronic renal failure who are maintained on HD exhibit an increased prevalence of SCI and that HSCRP is significantly associated with the presence of SCI in HD patients.
Anan
Futoshi
F
Department of Cardiology, Oita Red Cross Hospital, Oita 870-0033, Japan. anan-f@med.oita-u.ac.jp
Shimomura
Tsuyoshi
T
Kaku
Tadayuki
T
Kaneda
Koji
K
Imagawa
Masaharu
M
Tsukagawa
Hiroshi
H
Masaki
Takayuki
T
Nawata
Tomoko
T
Yonemochi
Hidetoshi
H
Eshima
Nobuoki
N
Saikawa
Tetsunori
T
Yoshimatsu
Hironobu
H
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D001921:Brain / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism*; D002544:Cerebral Infarction / Q000453:epidemiology* / Q000473:pathology; D003920:Diabetes Mellitus / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors
D015415:Biomarkers; D002097:C-Reactive Protein