title: High-sensitivity C-reactive protein level is a significant risk factor for silent cerebral infarction in patients on hemodialysis.
abstract: 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.
authors: Department of Cardiology, Oita Red Cross Hospital, Oita 870-0033, Japan. anan-f@med.oita-u.ac.jp
authors: Futoshi
authors: F
authors: Anan
authors: Tsuyoshi
authors: T
authors: Shimomura
authors: Tadayuki
authors: T
authors: Kaku
authors: Koji
authors: K
authors: Kaneda
authors: Masaharu
authors: M
authors: Imagawa
authors: Hiroshi
authors: H
authors: Tsukagawa
authors: Takayuki
authors: T
authors: Masaki
authors: Tomoko
authors: T
authors: Nawata
authors: Hidetoshi
authors: H
authors: Yonemochi
authors: Nobuoki
authors: N
authors: Eshima
authors: Tetsunori
authors: T
authors: Saikawa
authors: Hironobu
authors: H
authors: Yoshimatsu
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein