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C-reactive protein as an independent risk factor for carotid atherosclerosis in hemodialysis patients
Biserka Tirmenstajn-Janković1, Nada Dimković
1Zdravstveni centar Zajecar, Odeljenje nefrologije i hemodijalize. tribally@ptt.yu
Insights
Inflammation, indicated by C-reactive protein (CRP), is linked to early atherosclerosis in hemodialysis patients. Elevated CRP levels correlate with increased markers of subclinical atherosclerosis, highlighting inflammation's role.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biomarkers
Background:
- C-reactive protein (CRP) is a known cardiovascular disease risk factor.
- The link between CRP and early atherosclerosis, particularly in hemodialysis patients, requires further investigation.
Purpose of the Study:
- To investigate the relationship between CRP levels and indicators of subclinical atherosclerosis.
- To assess the role of inflammation in atherosclerosis development among hemodialysis patients.
Main Methods:
- B-mode ultrasound imaging was used to measure common carotid artery intima-media thickness, lumen diameter, and cross-sectional intima-media area (CSIM area).
- 43 hemodialysis (HD) patients and 21 healthy controls were included.
- CRP levels were measured, with inflammation defined as CRP > 10 mg/l.
Main Results:
- HD patients exhibited significantly higher CSIM area and lumen diameter compared to controls.
- 58.1% of HD patients showed inflammation (CRP > 10 mg/l).
- Inflammation was associated with higher ultrasonographic atherosclerosis markers and increased prevalence of atherosclerotic vascular diseases. Higher CSIM area correlated with elevated CRP, advanced age, and smoking.
Conclusions:
- Inflammation plays a key role in the development of atherosclerosis in hemodialysis patients.
- CRP is a valuable marker for assessing subclinical atherosclerosis in this population.
Abstract:
C-reactive protein is a known risk factor for cardiovascular diseases, but the association of CRP with the early phase of atherosclerosis has been insufficiently investigated. The aim of the present study was to investigate the relationship between CRP and indicators of subclinical atherosclerosis in hemodialysis patients. Intima-media thickness, lumen-diameter and cross-sectional intima-media area (CSIM area) of the common carotid artery were established using B-mode ultrasound imaging in 43 HD patients and 21 age- and gender-matched healthy controls. CSIM area and LD were significantly higher in HD patients compared with control subjects. Inflammation (CRP> 10 mg/l) was present in 58.1% of HD patients and was associated with higher values of all ultrasonographic markers of atherosclerosis, as well as higher prevalence of atherosclerotic vascular diseases. Higher CSIM area was associated with elevated CRP level (r=0.619, p=0.000), advanced age (R=0.704, p=0.005) and smoking habits (R=0.742, p=0.039). Results of our investigation support the concept on key role of inflammation in the development of atherosclerosis in HD patients.
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