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Inflammation, infection and cardiovascular events in chronic hemodialysis patients: a prospective study

Gianni Bellomo1, Giorgio Lippi, Paolo Saronio

  • 1Nephrology and Dialysis Unit, Assisi Hospital, Assisi, Italy. assidial@tin.it

Journal of Nephrology
|May 28, 2003
PubMed

Insights

Chronic hemodialysis patients with Chlamydia pneumoniae antibodies face a higher risk of cardiovascular events. C-reactive protein and C. pneumoniae serology predict cardiovascular morbidity in these patients.

Area of Science:

  • Nephrology
  • Infectious Disease
  • Cardiology

Background:

  • Cardiovascular disease is the leading cause of death in chronic hemodialysis (HD) patients.
  • Inflammation, potentially from infections like Chlamydia pneumoniae (C. pneumoniae) and Helicobacter pylori (H. pylori), is a risk factor for cardiovascular disease.
  • This study investigated the association between C-reactive protein (CRP), C. pneumoniae, and H. pylori serology with new cardiovascular events in HD patients.

Purpose of the Study:

  • To test the hypothesis that CRP levels and serological evidence of C. pneumoniae and H. pylori infections are associated with new cardiovascular events in chronic HD patients.
  • To identify predictors of cardiovascular morbidity in the HD population.

Main Methods:

  • 76 chronic HD patients were assessed for baseline CRP levels and IgG/IgA antibodies to C. pneumoniae and IgG to H. pylori.
  • Demographic and clinical risk factors (hypertension, diabetes, smoking, cholesterol, albumin) were recorded.
  • New cardiovascular events (myocardial infarction, ischemic stroke) were tracked over a 36-month follow-up, with logistic regression used for analysis.

Main Results:

  • Patients with C. pneumoniae antibodies had a significantly higher incidence of cardiovascular events (16.1 vs. 4.3 events/100 patient-years, p=0.017).
  • No significant difference in cardiovascular events was observed for H. pylori serology (12.2 vs. 11.7 events/100 patient-years, p=0.91).
  • Logistic regression identified C. pneumoniae seropositivity (OR 10.11, p=0.04) and CRP levels (OR 1.78, p=0.03) as independent predictors of cardiovascular events.

Conclusions:

  • CRP levels and C. pneumoniae antibodies are predictors of cardiovascular morbidity in chronic HD patients.
  • Antibodies to H. pylori were not found to be predictive of cardiovascular events in this cohort.
  • These findings highlight the role of specific infections and inflammation markers in cardiovascular risk stratification for HD patients.
Abstract

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