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接受血液透析的慢性肾脏病患者的高敏C反应蛋白、载脂蛋白与残余尿量

High-sensitivity C-reactive protein, apolipoproteins, and residual diuresis in chronic kidney disease patients undergoing hemodialysis.

作者信息

Borges Daniela Lemos, Lemes Helton Pereira, de Castro Ferreira Valéria, Filho Sebastião Rodrigues Ferreira

机构信息

Internal Medicine Department, Federal University of Uberlândia, Uberlândia, MG, Brazil.

Research Unit, Nefroclínica de Uberlândia, Uberlândia, Minas Gerais, Brazil.

出版信息

Clin Exp Nephrol. 2016 Dec;20(6):943-950. doi: 10.1007/s10157-016-1230-7. Epub 2016 Jan 14.

Abstract

BACKGROUND

Residual diuresis (RD) is the simplest method for measuring renal residual function in patients with chronic kidney disease (CKD). A reduction in RD is associated with intensification of the inflammatory process caused by uremia. However, little is known regarding the relation between RD and inflammatory markers in these patients. We verify possible associations among the hs-CRP, atherogenic factors, and RD, in patients with CKD undergoing hemodialysis.

METHODS

This study enrolled 80 patients with CKD undergoing hemodialysis. Patients were stratified according to RD in anuric (RD-) group (n = 47) and non-anuric (RD+) group (n = 33). Urine volumes were collected in a 24 h period during the interdialytic period. Serum high-sensitivity C-reactive protein (hs-CRP), and apolipoprotein (Apo) A1 and B levels were measured after fasting for 12 h.

RESULTS

Serum hs-CRP levels were higher in the RD- group than in the RD+ group (P = 0.015). In the total group, hs-CRP was significantly correlated with RD (r = - 0.25, P = 0.025) and Apo AI (r = - 0.25, P = 0.024). A greater proportion of patients had reduced plasma concentrations of Apo AI in the RD- group (31.9 %) compared with the RD+ group (9.1 %) (P = 0.014).

CONCLUSION

This study shows a relationship between RD and the hs-CRP in patients undergoing hemodialysis. Although the inflammatory state was verified in a large part of the CKD population, patients without RD had more elevated hs-CRP serum levels than those with RD.

摘要

背景

残余尿量(RD)是测量慢性肾脏病(CKD)患者肾脏残余功能的最简单方法。RD的降低与尿毒症引起的炎症过程加剧有关。然而,关于这些患者中RD与炎症标志物之间的关系知之甚少。我们验证了接受血液透析的CKD患者中,高敏C反应蛋白(hs-CRP)、致动脉粥样硬化因子与RD之间可能存在的关联。

方法

本研究纳入了80例接受血液透析的CKD患者。根据RD将患者分为无尿(RD-)组(n = 47)和非无尿(RD+)组(n = 33)。在透析间期的24小时内收集尿量。禁食12小时后测量血清高敏C反应蛋白(hs-CRP)、载脂蛋白(Apo)A1和B水平。

结果

RD-组的血清hs-CRP水平高于RD+组(P = 0.015)。在总人群中,hs-CRP与RD(r = -0.25,P = 0.025)和Apo AI(r = -0.25,P = 0.024)显著相关。与RD+组(9.1%)相比,RD-组中血浆Apo AI浓度降低的患者比例更高(31.9%)(P = 0.014)。

结论

本研究显示了接受血液透析患者的RD与hs-CRP之间的关系。尽管在大部分CKD人群中证实了存在炎症状态,但无RD的患者血清hs-CRP水平高于有RD的患者。

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