C - reactive protein levels in cerebral infaarctioninpatients on hemodialysis

ABSTRACT

Serum C-reactive protein [CRP] concentration issensitive marker of underlying systemic inflammation. Patientsunder continuous hemodialysis have an activated inflammatoryresponse, evidenced by increased serum CRP levels especiallyin patients with cerebral stroke. The study was performed toevaluate serum levels of CRP as inflammatory markers inpatients with stroke under continuous hemodialysis. The study was included 33 patients with chronicrenal failure under continuous hemodialysis divided into twogroups. Group I included 23 patients with acute stroke. Group II [control group] included 10 patients without stroke. All patientswere subjected to complete history and clinical examinationwith special emphasis to history of co-morbid conditions,hypertension, diabetes mellitus and cardiovascular disease.Serum creatinine, urea, CBC, albumin, lipid profile, calcium,fasting and post prandial blood sugar, sodium, potassium, serumuric acid, phosphorus, C-reactive protein and other investigationwere evaluated. In addition axial CT or MRI was performed atadmission and after 72 hours. The following parameterswere significantly higher in groupe I when compared to group II;ages [t=3.5. p< 0.01], CRP [t=7.1, p<0.001], serum creatinine [tett, p<0.0] and blood urea [t=4.3, p<0.01], while serumlevels of Hb% and serum calcium were significantly lower ingroup I when compared to group II [t=3.1, p<0.01 and t=2.2,p<0.05 respectively]. On the hand no significant differences inthe other studied parameters between two groups. Serum levelsof CRP were positively correlated with INR [r=520, p<0.05] and negatively correlated with serum calcium [r=0.580, p<0.05] and serum albumin [r=-540, p<0.05]. On the other hand nosignificant correlations were found between CRP and otherstudied parameters. According to ROC curve between group Iand II in CRP the cutoff were greater than 12 with sensitivity,specificity, Positive Perdictive Value and Negative PredictiveValue were 100% by accuracy 100%. Elevatedserum CRP could be a predictor of cerebrovascular stroke indialysis patients. Therefore, regular determination of serumCRP may be helpful to detect early signs of tissue damage andasymptomatic inflammation in these patients