title: Serum C-reactive protein levels and death and cardiovascular events in mild to moderate chronic kidney disease.
abstract: Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) disease. Elevated circulating levels of high sensitivity C-reactive protein (hsCRP) have been suggested to be associated with high risk of CV disease. It is uncertain whether the CV risk in CKD can be stratified by hsCRP levels in the Japanese population. Baseline data including serum hsCRP and creatinine levels were determined in the general population. Estimated glomerular filtration rate (eGFR) was calculated using a modified MDRD equation, and CKD was defined as eGFR below 60 mL/minute/1.73m(2). We analyzed 1,074 male subjects with mild to moderate CKD (mean age, 70.4 years). CV events (stroke and myocardial infarction) and all-cause death were surveyed prospectively. The CKD subjects were followed for 5.1 years, and 72 CV events and 115 all-cause deaths were found (composite endpoint). After adjustment for established CV risk factors, hazard ratios (HRs) for the endpoint were significantly increased according to the hsCRP quintile (P < 0.001), and HR for the highest (versus the lowest) quintile was 2.77 (95% CI; 1.61-4.77). These results suggest that serum hsCRP measurement is a useful tool for the risk stratification of CV events and death in CKD male subjects selected from the general population.
authors.affiliation: Department of Internal Medicine, Iwate Medical University, Morioka, Iwate, Japan.
authors.forename: Yorihiko
authors.initials: Y
authors.lastname: Koeda
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Tanaka
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Onoda
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Itai
authors.forename: Kozo
authors.initials: K
authors.lastname: Tanno
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Makita
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Tomiko
authors.initials: T
authors.lastname: Koyama
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Omama
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
authors.forename: Toru
authors.initials: T
authors.lastname: Kuribayashi
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein