Cardiovascular Risk Factors and Inflammation in Patients with Chronic Kidney Disease

Zheni Gjergji

Volume : VI, Issue : VII, July - 2016

Cardiovascular Risk Factors and Inflammation in Patients with Chronic Kidney Disease

Zheni Gjergji

Abstract :

Background. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). Markers of inflammation are also elevated in chronic renal patients. High levels of C– reactive protein (CRP) are a strong prognostic factor for cardiovascular morbidity and mortality both in non uremic and uremic patients. Increased CRP predicts cardiovascular mortality in hemodialysis patients (pts.). The aim of our study was to assess the relationship between the prevalence of CRP and the prevalence of cardiovascular disease in pre–dialysis and hemodialysis patients.Methods. 55 patients with CKD were enrolled in this study. 30 pts were in CKD not requiring dialysis (pre–dialysis) and were hospitalized at the Department of Internal Medicine in the University Hospital Center "Mother Teresa" in Tirana, Albania, during the period of September 2005 to May 2006, while 25 pts were dialyzed in Hospital Center of “Dr. Xh. Kongoli” Elbasan, Albania. The patients were divided in two groups based on the levels of CRP. The first group comprised patients that presented CPR levels lower than 6 mg/l and the second group comprised those presenting CRP levels higher than 6mg/l. For both groups we evaluated cardiovascular risk factors such as: systolic and diastolic blood pressure, albumin level, total cholesterol, anemia and dose of EPO treatment. Results: 50% of pre–dialysis and 52% of dialysis pts presented with elevated concentration of CRP > 10mg/l. In the first or pre–dialysis group, two patients (7%) presented with Ischemic Heart Disease, one patient (3%) had a history of myocardial infarction and 3 patients (10%) had congestive cardiac failure (CCF). In the dialysis group two patients (8%) presented ischemic heart disease and 5 patients (20%) with CCF. All patients with cardiovascular disease presented with elevated concentration of CRP. Considering all patients enrolled, a significant correlation (p<0.003), between elevated levels of CRP and cardiac morbidity has been found, but considering each group, pre–dialysis and dialysis, the correlation was not significant, most probably because of the limited number of patients enrolled.Conclusions. Regardless of the stage, CKD patients (pre–dialysis and dialysis) with elevated levels of CRP (as a single CVD marker) were associated with higher cardiovascular morbidity