title: Association between C-reactive protein and biomarkers of bone and mineral metabolism in chronic hemodialysis patients: a cross-sectional study.
abstract: 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.
authors.affiliation: 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
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Tsai
authors.forename: Hwee-Yeong
authors.initials: HY
authors.lastname: Ng
authors.forename: Yih
authors.initials: Y
authors.lastname: Su
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Lee
authors.forename: Lung-Chih
authors.initials: LC
authors.lastname: Lee
authors.forename: Terry Ting-Yu
authors.initials: TT
authors.lastname: Chiou
authors.forename: Shang-Chih
authors.initials: SC
authors.lastname: Liao
authors.forename: Kao-Tai
authors.initials: KT
authors.lastname: Hsu
mesh_terms: 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
chemical_list: D015415:Biomarkers; D008903:Minerals; D010710:Phosphates; D002097:C-Reactive Protein; D002118:Calcium