Association between C-reactive protein and biomarkers of bone and mineral metabolism in chronic hemodialysis patients: a cross-sectional study.
OBJECTIVE
Both chronic inflammation and dysregulation of bone and mineral metabolism are closely related with long-term outcomes of dialysis patients. Our objective was to investigate the relationship between these two abnormalities.


METHODS
This was a cross-sectional study.


METHODS
This study was performed at a hospital-based hemodialysis center.


METHODS
We enrolled 448 (male, 198; female, 250) clinically stable hemodialysis patients. Patients with chronic inflammatory disease, malignancy, or viral hepatitis were excluded. Their age (mean +/- SD) was 57.4 +/- 12.5 years.


METHODS
Biomarkers, including high-sensitivity C-reactive protein (hsCRP), total calcium, phosphate, and intact parathyroid hormone levels, were measured and compared with the recommended range in the K/DOQI guidelines. Correlations between these parameters were analyzed, and factors independently associated with hsCRP and the calcium phosphate product (Ca x P) were identified by regression analysis.


RESULTS
Most patients did not achieve the K/DOQI recommended therapeutic range in the four parameters, and only 50 patients (11%) met their treatment goals. The hsCRP level was directly related to calcium, phosphate, and Ca x P. Patients who achieved the guidelines' range had lower hsCRP levels (1.97 mg/L vs. 2.71 mg/L, P < .05). A high hsCRP level (> or = 10 mg/L) was associated with higher calcium, phosphate, and Ca x P levels, and lower albumin levels. Serum albumin, Ca x P, alkaline phosphatase, and diabetes independently predicted hsCRP levels.


CONCLUSIONS
There is a strong association between chronic inflammation and the disturbance of bone mineral metabolism in chronic hemodialysis patients.
Lee
Chien-Te
CT
Division of Nephrology, Department of Medicine, Chang-Gung Memorial Hospital-Kaohsiung Medical Center, Chang-Gung University College of Medicine, Niao-Sung Shang, Kaohsiung, Hsien, Taiwan. ctlee33@adm.cgmh.org.tw
Tsai
Yu-Che
YC
Ng
Hwee-Yeong
HY
Su
Yih
Y
Lee
Wen-Chin
WC
Lee
Lung-Chih
LC
Chiou
Terry Ting-Yu
TT
Liao
Shang-Chih
SC
Hsu
Kao-Tai
KT
D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000097:blood*; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis
D015415:Biomarkers; D008903:Minerals; D010710:Phosphates; D002097:C-Reactive Protein; D002118:Calcium