Serum C-reactive protein on the prognosis of oncology patients with acute renal failure: an observational cohort study.
BACKGROUND
We undertook this study to evaluate the significance of the C-reactive protein level (CRP) as a prognostic factor in oncology patients with acute renal failure (ARF) during nephrology consultation.


METHODS
The study was comprised of a cohort of 375 consecutive oncology patients who had been admitted to a university-affiliated hospital between March 1998 and April 2006 and had been diagnosed with ARF. One hundred and fifty nine patients with ARF who matched at least one of the RIFLE criteria on increased serum creatinine were included for subsequent analysis. We used a Cox proportional hazard model.


RESULTS
Clinical pathological variables were compared among patients with serum CRP levels > or =8 mg/dL (exposed group; cut-off point: median) and patients with serum CRP level <8 mg/dL (control group). In-hospital mortality rates associated with CRP levels were 53.8% for > or =8 mg/dL and 21.5% for <8 mg/dL (p <0.001). After adjusted analysis, the presence of a CRP level > or =8 mg/dL was significantly associated with an increased in-hospital mortality (HR 2.10; 95% CI: 1.17-3.78) than in those patients with similar Liano scoring, the same RIFLE classes, and the same treatment for ARF. In addition, each increment of 1 mg/dL of serum CRP was associated with an adjusted 4% increment of in-hospital mortality (HR 1.04, 95% CI: 1.01-1.06).


CONCLUSIONS
CRP levels at nephrology consultation were an independent predictor of death in this cohort of oncology patients with ARF. Patients with levels > or =8 mg/dL may be considered at higher risk of death.
Perez Valdivieso
Jose Ramon
JR
Department of Anesthesia and Critical Care, Clinica Universitaria, University of Navarra, Pamplona, Spain. jrpvaldi@unav.es
Bes-Rastrollo
Maira
M
Monedero
Pablo
P
Olaondo
Luis Lopez
LL
de Irala
Jokin
J
Lavilla
Francisco Javier
FJ
D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications* / Q000401:mortality / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000150:complications* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate
D015415:Biomarkers; D002097:C-Reactive Protein