C-reactive protein as a predictor of cardiovascular events in elderly patients with chronic kidney disease.
BACKGROUND
Few studies have evaluated the relationship between high-sensitivity C-reactive protein (hs-CRP) and vascular events in the elderly with chronic kidney disease (CKD).


METHODS
The association of hs-CRP with vascular events was examined according to CKD status in 3,166 participants of the Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg, Bavaria (INVADE study). CKD was defined as a creatinine clearance <60 ml/min estimated by the Cockcroft-Gault formula. hs-CRP was used as a binary variable > or <2.1 mg/L (median value). Vascular events were defined as a composite of myocardial infarction, stroke and vascular death.


RESULTS
After 4 years of follow-up, 204 participants (6.4%) experienced a major cardiovascular event. High hs-CRP levels and CKD at baseline were associated with a greater risk of vascular events. Compared with patients with low hs-CRP and non-CKD, the adjusted hazard ratio (95% confidence interval) for vascular events was 1.42 (1.11-2.21) for low hs-CRP and CKD, 1.57 (1.21-2.34) for high hs-CRP and non-CKD and 1.93 (1.45-2.89) for high hs-CRP and CKD.


CONCLUSIONS
These results suggest that high hs-CRP levels provide prognostic information in patients with CKD.
Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado 80045, USA. diana.jalal@ucdenver.edu
Diana
D
Jalal
Michel
M
Chonchol
Thorleif
T
Etgen
Dirk
D
Sander
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000401:mortality; D016009:Chi-Square Distribution; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
D015415:Biomarkers; D002097:C-Reactive Protein; D003404:Creatinine