Inflammation as a cardiovascular risk factor in patients with different stages of renal disease

Abstract

Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). Inflammatory markers are also elevated in patients with chronic kidney disease. High C-reactive protein (CRP) levels are important prognostic factors for cardiovascular morbidity and mortality in non-uremic and uremic patients. High CRP predicts cardiovascular mortality in haemodialysis patients.
Objectives: The aim of our study was to evaluate the association between CRP prevalence and cardiovascular disease in predialysis and haemodialysis patients..
Methods: In our study were included 55 patients with CKD. 30 patients with chronic kidney disease who did not require dialysis (predialysis) were hospitalized in the Department of Internal Medicine, University Hospital center "Mother Teresa", Tirana, and 25 patients were hospitalized in the Department of Internal Medicine, Xh. Kongoli – Elbasan. Patients were divided into two groups according to their CRP levels. The first group included patients with CRP levels below 6 mg/l, and the second group included patients with CRP levels above 6 mg/l. We evaluated cardiovascular risk factors such as systolic and diastolic blood pressure, albumin level, total cholesterol, anaemia, and EPO therapy in both groups..
Results: High CRP concentrations >10 mg/l occurred in 50% of predialysis patients and 52% of dialysis patients. In the first or predialysis group, two patients (7%) had ischemic heart disease, one patient (3%) had a history of myocardial infarction, and three patients (10%) had heart failure (CCF). In the dialysis group, 2 patients (8%) developed ischemic heart disease and 5 patients (20%) developed CCF. CRP concentrations were high in all patients with heart disease. When all enrolled patients were considered, there was a significant correlation between high CRP levels and the incidence of cardiovascular disease (p<0.003), but the lack of significance when all groups, were considered..
Conclusions: High levels of CRP (as a CVD marker) were associated with more cardiovascular risk factors in all patients, regardless of CKD stage, demonstrating that markers of inflammation have an important impact for cardiovascular morbidities in this vulnerable population.