Related Experiment Videos
Relationship between C-reactive protein, albumin, and cardiovascular disease in patients with chronic kidney disease
Vandana Menon1, Xuelei Wang, Tom Greene
1Department of Medicine, Division of Clinical Care Research, Tufts-New England Medical Center, Boston, MA, USA.
Insights
C-Reactive protein (CRP) levels are linked to malnutrition and cardiovascular disease (CVD) in early kidney disease. Higher CRP is associated with lower albumin and increased CVD risk, independent of kidney function.
Area of Science:
- Nephrology
- Cardiology
- Nutritional Science
Background:
- C-Reactive protein (CRP) elevation is noted in kidney failure, potentially linked to malnutrition and cardiovascular disease (CVD).
- Limited data exist on CRP levels in earlier stages of kidney disease concerning glomerular filtration rate (GFR), nutritional status, and CVD.
- Understanding these relationships is crucial for managing patients with chronic kidney disease (CKD).
Purpose of the Study:
- To investigate the associations between C-reactive protein (CRP) levels and glomerular filtration rate (GFR), nutritional indices, and cardiovascular disease (CVD) risk factors in patients with earlier stages of chronic kidney disease.
- To determine if CRP levels are independently associated with serum albumin levels and CVD prevalence in this population.
Main Methods:
- Analysis of C-Reactive protein (CRP) levels from 801 participants in the Modification of Diet in Renal Disease (MDRD) Study.
- Comparison of CRP distributions between the MDRD Study and the National Health and Nutrition Examination Survey (NHANES).
- Examination of associations between CRP, GFR, nutritional indices, serum albumin, and CVD risk factors within the MDRD Study cohort.
Main Results:
- CRP levels were similar between NHANES and MDRD Study participants.
- In the MDRD Study, CRP correlated positively with body fat and CVD risk factors, and inversely with serum albumin and energy intake.
- High CRP levels (>0.6 mg/dL) were independently associated with lower mean serum albumin levels and increased odds of CVD, even after adjusting for traditional risk factors.
Conclusions:
- Glomerular filtration rate (GFR) does not significantly influence C-reactive protein (CRP) levels in early chronic kidney disease.
- CRP levels are independently linked to lower serum albumin levels and higher prevalence of cardiovascular disease (CVD).
- Inflammation, indicated by CRP, may play a role in the development of malnutrition and CVD in patients with early-stage kidney disease.
Background:
C-Reactive protein (CRP) level is elevated in kidney failure and may be related to malnutrition and cardiovascular disease (CVD). Data are limited regarding relationships between CRP levels and glomerular filtration rate (GFR), nutritional indices, and CVD in patients with earlier stages of kidney disease.
Methods:
CRP was assayed from samples from the Modification of Diet in Renal Disease (MDRD) Study (n = 801). CRP distributions were compared between the MDRD Study and National Health and Nutrition Examination Survey (NHANES; 1999 to 2000). Associations between CRP level and GFR, nutritional indices, serum albumin levels, and CVD risk factors were examined in the MDRD Study.
Results:
Geometric means of CRP, adjusted for age and sex, were similar in NHANES (0.23 mg/dL) and the MDRD Study (0.22 mg/dL). In the MDRD Study, CRP level was related directly to measures of body fat and CVD risk factors, inversely with serum albumin level and energy intake, and unrelated to GFR. In multivariable analysis adjusting for other determinants of serum albumin level, high CRP level (>0.6 mg/dL) was associated with a 0.07-g/dL (0.7-g/L; 95% confidence interval [CI], 0.03 to 0.12) lower mean serum albumin level. After adjusting for traditional CVD risk factors, the odds of CVD were 1.73 (95% CI, 1.07 to 2.78) times greater in subjects with a high CRP level.
Conclusion:
GFR level does not appear to influence CRP level in the earlier stages of chronic kidney disease. CRP levels are independently associated with serum albumin level and CVD prevalence. Inflammation may be involved in the pathophysiological state of malnutrition and CVD in the earlier stages of predominantly nondiabetic kidney disease.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Chronic Kidney Disease I: Introduction
01:28Chronic Kidney Disease III: Interprofessional Care
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Diabetic Nephropathy
01:18Chronic Kidney Disease IV: Nursing Management