Comparison of Nutritional Status According to Serum C-reactive Protein Concentration in Hemodialysis Patients / 대한신장학회잡지

ABSTRACT

Serum C-reactive protein(sCRP) is an acute-phase reactant that exhibiting negative correlation with serum albumin concentration. It was reported that sCRP is an independent predictor of survival in both hemodialysis and peritoneal dialysis patients, and an acute phase inflammation could be preceded by protein catabolism, hypoalbuminemia, anorexia and even atherosclerotic cardiovascular disease. We have evaluated serum biochemical parameters including albumin and prealbumin, Kt/Vurea, nPCR, SGA score, anthropometric parameters and diet history in 30 ESRD patients maintained on chronic hemodialysis subdivided by sCRP concentration. Upon comparing the two subgroups[high CRP group(sCRP >or= 0.4mg/dL), n=15 vs. normal CRP group (sCRP<0.4mg/dL), n=15], high CRP group showed significantly lower levels of hemoglobin(9.3+/- 0.7 vs. 9.8+/-0.6g/L, p<0.05), hematocrit(28.3+/-2.3 vs 29.8+/-1.696, p<0.05), creatinine(9.6+/-3.1 vs. 12.2+/-2.5mg/dL, p<0.05), prealbumin(20.9+/-5.0 vs. 25.8+/-6.4mg/dL, p< 0.05), SGA score(5.0+/-1.2 vs. 5.9+/-0.7, p<0.05), and percent of patients who have higher nPCR than protein intake(85.7 vs. 28.6%, p<0.05). Ferritin was significantly higher in high CRP group(503.1+/-205.7 vs. 323.3+/-186.6, p<0.05). There were no differences in age, sex, duration of hemodialysis, prevalence of diabetic nephropathy and cardiovascular disease, Kt/Vurea, nPCR, residual renal function, amount of protein intake and other nutritional parameters. In conclusion, there was higher probability of malnutrition, anemia and protein catabolism in hemo-dialysis patients with elevated sCRP concentration.