C反应蛋白是血液透析患者死亡率的有力预测指标。

C-reactive protein is a strong predictor of mortality in hemodialysis patients.

作者信息

Racki Sanjin, Zaputović Luka, Mavrić Zarko, Vujicić Bozidar, Dvornik Stefica

机构信息

Department of Nephrology and Dialysis, Rijeka University Hospital, Rijeka, Croatia.

出版信息

Ren Fail. 2006;28(5):427-33. doi: 10.1080/08860220600683581.

DOI:10.1080/08860220600683581

PMID:16825093

Abstract

BACKGROUND

To establish the baseline cutoff value of C-reactive protein (CRP) that would predict increased overall and cardiovascular mortality in patients with end-stage renal disease (ESRD).

METHODS

A cohort of 270 prevalent hemodialysis patients treated at Rijeka University Hospital was eligible for the study. Monthly CRP measurements were performed for three consecutive months. Only the patients with CRP values varying <20% were included (n=256). During the follow-up, 24 patients were transplanted and therefore excluded from the analysis. The CRP cutoff point of 6.2 mg/L was established by Receiver Operating Characteristic curve. The patients were divided into four groups according to their CRP values. Group 1 included 80 (34.5%) patients with CRP <3.0 mg/L, group 2 included 23 (9.9%) patients with CRP 3.0-6.1 mg/L, group 3 consisted of 18 (7.7%) patients with CRP 6.2-10.0 mg/L, and group 4 included 111 (47.9%) patients with CRP >10.0 mg/L. The survival was evaluated by Kaplan-Meier curve.

RESULTS

During the two-year follow-up, 59 patients died. The major cause of death was cardiovascular disease (64%). Significantly higher overall and cardiovascular mortality was observed in group 3 when compared with groups 1 and 2 (chi2=11.97; P < 0.001) and in group 4 when compared with groups 1 and 2 (chi2=14.40; P<0.001). Compared with survivors, non-survivors had a higher median CRP value (19.0 [1.5-99.7] mg/L vs. 2.3 [0.1-49.1] mg/L, respectively; P<0.001).

CONCLUSION

Serum concentration of CRP above 6.2 mg/L is a strong predictor of overall and cardiovascular mortality in patients with ESRD.

摘要

背景

确定可预测终末期肾病（ESRD）患者全因死亡率和心血管死亡率升高的C反应蛋白（CRP）基线临界值。

方法

里耶卡大学医院收治的270例维持性血液透析患者纳入本研究。连续三个月每月检测CRP。仅纳入CRP值变化<20%的患者（n = 256）。随访期间，24例患者接受移植，因此被排除在分析之外。通过受试者工作特征曲线确定CRP临界值为6.2 mg/L。根据患者CRP值分为四组。第1组包括80例（34.5%）CRP<3.0 mg/L的患者，第2组包括23例（9.9%）CRP为3.0 - 6.1 mg/L的患者，第3组由18例（7.7%）CRP为6.2 - 10.0 mg/L的患者组成，第4组包括111例（47.9%）CRP>10.0 mg/L的患者。通过Kaplan-Meier曲线评估生存率。

结果

在两年随访期间，59例患者死亡。主要死亡原因是心血管疾病（64%）。与第1组和第2组相比，第3组的全因死亡率和心血管死亡率显著更高（χ2 = 11.97；P < 0.001），与第1组和第2组相比，第4组也是如此（χ2 = 14.40；P < 0.001）。与幸存者相比，非幸存者的CRP中位数更高（分别为19.0 [1.5 - 99.7] mg/L和2.3 [0.1 - 49.1] mg/L；P < 0.001）。