title: The influence of inflammatory markers and CRP predictive value in relation to the target hemoglobin level in patients on chronic hemodialysis.
abstract: The aim of this study was to determine the influence of inflammatory markers, predictive values of CRP and target hemoglobin (Hb) in patients on chronic hemodialysis.
  
  
  METHODS
  Made is a cross-sectional study of inflammatory agents serum levels-CRP, fibrinogen and ferritin before hemodialysis in 114 patients divided into two groups according to the achieved or unachieved target hemoglobin level in the Cantonal Hospital in Zenica.
  
  
  RESULTS
  The 57 patients (test group) did not reached the target hemoglobin in the range from 10-12 g/dl and CRP values were significantly higher compared to the control group (57 patients) who had reached targeted hemoglobin values. Levels of fibrinogen and ferritin were not significantly different between the control and the test group. CRP values are in negative correlation with the Hb concentration, while fibrinogen and ferritin values had a positive correlation. Significant negative correlation was only found in case of CRP, respectively, higher CRP was at lower levels of blood Hb. It was found that the predictive value of CRP is 6.5 mg/L to achieve target Hb level. If the CRP increases by 1 mg/L, possibilities to achieve the target Hb level in dialysis patients is reduced by 7.5%, with a sensitivity of 51% and specificity of 77%. Ferritin was elevated due to iatrogenic iron saturation, because all patients received intravenous iron and was treated with erythropoietin. By identification and analysis of inflammatory agents and duration ofhemodialysis, are explored the primary influence on hematopoiesis, of course, with the primary application of erythropoietin and adjuvant agents. It has been shown that CRP alone has an impact on the target Hb level, depending on the hemodialysis duration.
  
  
  CONCLUSIONS
  The research results show how what looks as routine findings may be helpful in the timely detection of threatening complications and their treatment, and provide extended and improved quality of life for patients on hemodialysis.
authors.affiliation: Clinic of Urgent Medicine, Clinical Center of Sarajevo University, Bosnia and Herzegovina. adnan.musanovic74@gmail.com
authors.forename: Adnan
authors.initials: A
authors.lastname: Musanovic
authors.affiliation: Clinic of Nephrology, University Clinical Center Tuzla, Bosnia and Herzegovina.
authors.forename: Senaid
authors.initials: S
authors.lastname: Trnacevic
authors.affiliation: Department of Hearth Diseases and Rheumatism, Clinical Center of Sarajevo University, Bosnia and Herzegovina.
authors.forename: Mevludin
authors.initials: M
authors.lastname: Mekic
authors.affiliation: Department of Radiology, Cantonal Hospital Zenica, Bosnia and Herzegovina.
authors.forename: Affan
authors.initials: A
authors.lastname: Musanovic
mesh_terms: D000368:Aged; D000740:Anemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000276:immunology / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000276:immunology / Q000378:metabolism*; D005340:Fibrinogen / Q000276:immunology / Q000378:metabolism*; D005937:Glucaric Acid; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects; D013395:Sucrose / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D005290:Ferric Compounds; D006454:Hemoglobins; D004921:Erythropoietin; D013395:Sucrose; D005340:Fibrinogen; D002097:C-Reactive Protein; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid