C-Reactive Protein Haplotype Predicts Serum C-Reactive Protein Levels But Not Cardiovascular Disease Risk in a Dialysis Cohort

Zhang, Lin; Kao, W. H. Linda; Berthier-Schaad, Yvette; Plantinga, Laura C.; Fink, Nancy E.; Smith, Michael W.; Coresh, Josef

doi:10.1053/j.ajkd.2006.10.008

Cited by 36 publications

(24 citation statements)

References 31 publications

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“…Serum albumin levels [6,7], serum C-reactive protein (CRP) concentrations [5,8] and body mass index (BMI) [9,10,11] have been reported as predictors of all-cause and CVD mortality, and we have reported that increased levels of CRP can predict future events in the coronary artery and peripheral arteries after intervention [12,13]. In contrast, other groups have reported that these factors are not associated with mortality [1,14,15]. …”

Section: Introductionmentioning

confidence: 54%

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Combined Values of Serum Albumin, C-Reactive Protein and Body Mass Index at Dialysis Initiation Accurately Predicts Long-Term Mortality

Takahashi¹,

Ito²,

Takahashi

et al. 2012

Am J Nephrol

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Background: Protein-energy wasting and chronic inflammation are prevalent in patients with end-stage renal disease (ESRD). We investigated the combination of serum albumin, C-reactive protein (CRP) and body mass index (BMI) at initiation of hemodialysis therapy as a predictor of all-cause and cardiovascular disease (CVD) mortality in Japanese ESRD patients. Methods: A total of 1,228 consecutive Japanese ESRD patients on hemodialysis therapy were enrolled and followed for up to 10 years. Patients were divided into quartiles according to levels of albumin, CRP and BMI. Furthermore, to clarify the joint role of these factors, albumin <3.5 g/dl, CRP >4.0 mg/l and BMI <19.6 were defined as risk factors using receiver operating characteristic analysis; thereafter, patients were divided into groups according to the positive number of these factors. Results: Adjusted hazard ratios (HRs) for lower serum albumin, elevated CRP and lower BMI for 10-year all-cause mortality were 1.97, 3.13 and 2.61, respectively. Regarding the combination of these variables, adjusted HRs for mortality were 2.31, 4.28 and 8.07, respectively, in patients having any one factor, any two factors and all three factors. The C-index for an established risk model with these three positive markers was the most accurate for predicting mortality (0.768), as compared to other models with one or two markers. Similar results were seen for CVD mortality. Conclusions: Serum albumin, CRP and BMI at the start of hemodialysis therapy were able to individually stratify the risk of long-term mortality in ESRD patients. Furthermore, a combination of these variables could more accurately predict mortality.

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Section: Introductionmentioning

confidence: 54%

“…Individual analyses using these markers do not always reflect mortality [14,15]. Furthermore, most of the AUCs on ROC curves for each marker were previously reported to be less than 0.7, which suggests low accuracy when predicting mortality [22,23].…”

Section: Discussionmentioning

confidence: 99%

Combined Values of Serum Albumin, C-Reactive Protein and Body Mass Index at Dialysis Initiation Accurately Predicts Long-Term Mortality

Takahashi¹,

Ito²,

Takahashi

et al. 2012

Am J Nephrol

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“…As reviewed by Zoccali (11), many biomarkers have been tested in the dialysis population, including ferritin (17), high-sensitivity C-reactive protein (hsCRP) (18)(19)(20)(21)(22), IGF-1 (23,24), IL-6 (18,22,25), soluble intracellular adhesion molecule (sICAM-1), soluble vascular cellular adhesion molecule 1 (sVCAM-1) (26,27), troponin T (TnT) (28), TNF (29), platelet count (PLT) (30), and white blood cell (WBC) (31). These risk biomarkers have each been shown to independently predict both clinical CVD and mortality in ESRD, but they often rely on relatively small materials, and multivariate testing and adjustment for common confounders, such as residual renal function, have not been performed consistently.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of Cardiovascular Disease and Mortality Risk in Patients with Advanced CKD

Sun

Axelsson

Machowska

et al. 2016

CJASN

156

125

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Background and objectives The high risk of cardiovascular disease (CVD) and premature death in patients with CKD associates with a plethora of elevated circulating biomarkers that may reflect distinct signaling pathways or simply, are epiphenomena of CKD. We compared the predictive strength of 12 biomarkers analyzed concomitantly in patients with stage 5 CKD.Design, setting, participants, & measurements From 1994 to 2014, 543 patients with stage 5 CKD (median age =56 years old; 63% men; 199 patients had CVD) took part in our study on malnutrition, inflammation, and CVD in incident dialysis patients. Circulating levels of albumin, ferritin, high-sensitivity C-reactive protein (hsCRP), IGF-1, IL-6, orosomucoid, troponin T (TnT), TNF, soluble intracellular adhesion molecule, soluble vascular cellular adhesion molecule 1 (sVCAM-1), and platelet and white blood cell (WBC) counts were analyzed as predictors of the presence of clinically overt CVD at baseline, protein-energy wasting (PEW), and subsequent all-cause mortality. During follow-up for a median of 28 months, there were 149 deaths, 81 of which were caused by CVD.Results Most biomarkers were elevated compared with reference values and--except for albumin, ferritin, and IGF-1-higher in patients with CVD. In receiver operating characteristic analysis, age, IL-6, TnT, hsCRP, and IGF-1 were classifiers of baseline CVD and predictors of all-cause mortality. In addition to age, diabetes mellitus, smoking (for CVD), and PEW, only IL-6, relative risk (RR) 1.10 and 95% confidence interval ([95% CI], 1.02 to 1.19), sVCAM-1 RR 1.09 (95% CI, 1.01 to 1.17), and serum albumin RR 0.89 (95% CI, 0.83 to 0.95) associated with baseline CVD, and only WBC, hazard ratio (HR) 1.94 (95% CI, 1.34 to 2.82), IL-6 HR 1.79 (95% CI, 1.20 to 2.67), and TNF HR 0.65 (95% CI, 0.44 to 0.97) predicted all-cause mortality.Conclusions In addition to age and comorbidities, only IL-6, sVCAM-1, and albumin could-independently of other biomarkers-classify clinical CVD, and only IL-6, WBC, and TNF could-independently of other biomarkers-predict all-cause mortality risk. These data underscore the robustness of IL-6 as a classifier of clinically overt CVD and predictor of all-cause mortality in patients with stage 5 CKD.

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“…cohort of 504 white and 244 African-American incident dialysis patients no association was detected between CRP gene variation and CVD risk in either whites or African Americans [16].…”

Section: C-reactive Protein Polymorphismsmentioning

confidence: 99%

High-Sensitivity C-Reactive Protein: To Measure or not to Measure?~!2009-10-29~!2009-12-22~!2010-04-08~!

Nakou¹,

Elisaf²,

Liberopoulos³

2012

TOCCHEMJ

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Abstarct: Based on evidence that inflammatory processes play a fundamental role in the development of cardiovascular disease, high sensitivity C-reactive protein (hsCRP) is considered a powerful risk marker for cardiovascular events. Irrespective of a potential role in risk prediction, recent evidence implicates a direct involvement of CRP per se in the pathogenesis of atherosclerotic cardiovascular disease. In the present article we review the literature concerning clinical studies assessing the association between hsCRP concentration and cardiovascular disease. Measurement of hsCRP levels may help guiding medical treatment initiation and adjustment in certain groups of subjects both in the primary and secondary prevention.

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C-Reactive Protein Haplotype Predicts Serum C-Reactive Protein Levels But Not Cardiovascular Disease Risk in a Dialysis Cohort

Cited by 36 publications

References 31 publications

Combined Values of Serum Albumin, C-Reactive Protein and Body Mass Index at Dialysis Initiation Accurately Predicts Long-Term Mortality

Combined Values of Serum Albumin, C-Reactive Protein and Body Mass Index at Dialysis Initiation Accurately Predicts Long-Term Mortality

Biomarkers of Cardiovascular Disease and Mortality Risk in Patients with Advanced CKD

High-Sensitivity C-Reactive Protein: To Measure or not to Measure?~!2009-10-29~!2009-12-22~!2010-04-08~!

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