Related Experiment Videos

Precision of biomarkers to define chronic inflammation in CKD

Robert LaClair1, Kalisha O'Neal, Susan Ofner

  • 1Indiana University School of Medicine, Indianapolis, Indiana, USA.

American Journal of Nephrology
|May 29, 2008
PubMed

Insights

Inflammatory biomarkers like C-reactive protein and IL-6 show significant intrapatient variation in dialysis patients. This wide fluctuation limits their use as reliable surrogate endpoints in clinical trials.

Area of Science:

  • Nephrology
  • Clinical Chemistry
  • Biomarker Research

Background:

  • Inflammatory biomarkers are linked to cardiovascular disease and mortality in dialysis patients.
  • Their clinical utility and role as surrogate endpoints remain uncertain.
  • Intrapatient variability is a key factor influencing their interpretation.

Purpose of the Study:

  • To quantify the intrapatient variation of key inflammatory biomarkers.
  • Specifically assess C-reactive protein, IL-6, fetuin-A, and albumin.
  • Evaluate these variations in a cohort of dialysis patients.

Main Methods:

  • Monthly assessments of biomarkers in apparently healthy dialysis patients.
  • Patients utilized either a tunneled dialysis catheter or fistula.
  • Intraclass correlation coefficients calculated to measure intersubject variance.

Main Results:

  • Significant within-subject variation observed (31-46% of total variation).
  • No significant difference in biomarker levels between catheter and fistula users.
  • Acute infections caused rapid, marked changes in biomarker levels.

Conclusions:

  • Wide fluctuations in these biomarkers limit their use as surrogate endpoints in clinical trials.
  • Variability exists even in clinically healthy individuals.
  • Further research needed to understand and manage biomarker variability in dialysis patients.
Abstract

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...