The prognostic impact of fluctuating levels of C-reactive protein in Brazilian haemodialysis patients: a prospective study

摘要: Background. A single elevated C-reactive protein (CRP) value predicts mortality in haemodialysis (HD) patients, but the relative importance of repeated vs occasional positive systemic inflammatory response findings is not known. Methods. To assess influence on survival inflammation, CRP, serum albumin (SAlb) and fibrinogen were analysed bimonthly 180 HD patients (54% male, 49±14 years). Clinically significant inflammation was defined as CRP >5.1 mg/l, based receiver operating characteristics curve for predictor death. Based four consecutive measurements assigned into three groups: group 1 (n ¼ 74; 41%), no (CRP � 5.1 mg/l all measurements); 2 65; 36%), (1–3 mg/l); 3 41; 23%), persistent (all mg/l). The nutritional status evaluated by subjective global assessment (SGA) body mass index (BMI), (21 months follow-up) Kaplan–Meier Cox model. Results. median range values (mg/l) 1, were: 3.2 (3.2–5.1), 3.6 (3.2–54.9) 13.8 (5.2–82), respectively (P<0.001), whereas prevalence malnutrition, assessed SGA BMI, did differ significantly between groups. rate analysis different among groups ( 12.34; P 0.0004). Patients showed highest (34%; 0.001), compared with (8%) (14%; 0.01), respectively, there difference 2. Age, S-Alb level independent predictors mortality. Conclusion. a elevation had higher than elevation. Thus, persistent, rather occasional, an important death patients.