Erythrocyte sedimentation rate, an underestimated tool in chronic renal failure

Brouillard, M; Reade, Richard; Boulanger, Éric; Cardon, G.; Dracon, M; Dequiedt, P; Pagniez, Dominique

doi:10.1093/oxfordjournals.ndt.a027143

Cited by 23 publications

(19 citation statements)

References 17 publications

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“…This chronic vascular injury might result in low compliance and leaking of the vessels, predisposing to both asymptomatic (microbleed) hemorrhage and sICH. Elevated ESR levels can be seen in patients with chronic kidney disease 32,33 ; however, there was no collinearity between the two in our population. Given the apparent association between elevated ESR and intracerebral hemorrhage, additional studies with pathological correlation to determine the underlying pathophysiologic mechanisms are needed.…”

Section: Discussionmentioning

confidence: 49%

Predicting Symptomatic Intracerebral Hemorrhage Versus Lacunar Disease in Patients With Longstanding Hypertension

Marsh

Gottesman

Hillis

et al. 2014

Stroke

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Background and Purpose Hypertension results in a spectrum of subcortical cerebrovascular disease. It is unclear why some individuals develop ischemia and others develop hemorrhage. Risk factors may differ for each population. We identify factors that predispose an individual to subcortical symptomatic intracerebral hemorrhage (sICH) compared with ischemia. Methods Demographic and laboratory data were prospectively collected for hypertensive patients presenting with ischemic stroke or sICH during an 8.5-year period. Neuroimaging was retrospectively reviewed for acute (subcortical lacunes [<2.0 cm] versus subcortical sICH) and chronic (periventricular white matter disease and cerebral microbleeds) findings. We evaluated the impact of age, race, sex, serum creatinine, erythrocyte sedimentation rate, low-density lipoprotein, presence of periventricular white matter disease or cerebral microbleeds, and other factors on the risk of sICH versus acute lacune using multivariate logistic regression. Results Five hundred seventy-one patients had subcortical pathology. The presence of cerebral microbleeds (adjusted odds ratio [OR], 3.39; confidence interval [CI], 2.09–5.50) was a strong predictor of sICH, whereas severe periventricular white matter disease predicted ischemia (OR, 0.56 risk of sICH; CI, 0.32–0.98). This association was strengthened when the number of microbleeds was evaluated; subjects with >5 microbleeds had an increased risk of sICH (OR, 4.11; CI, 1.96–8.59). It remained significant when individuals with only cortical microbleeds were removed (OR, 1.77, CI, 1.13–2.76). An elevated erythrocyte sedimentation rate (OR, 1.19 per 10 mm/h increase; CI, 1.06–1.34) was significantly associated with sICH, whereas low-density lipoprotein was associated with ischemic infarct (OR, 0.93 risk of sICH per 10 mg/dL increase; CI, 0.86–0.99). Conclusions Subclinical pathology is the strongest predictor of the nature of subsequent symptomatic event. Low-density lipoprotein and erythrocyte sedimentation rate may also have a role in risk stratification.

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Section: Discussionmentioning

confidence: 49%

Predicting Symptomatic Intracerebral Hemorrhage Versus Lacunar Disease in Patients With Longstanding Hypertension

Marsh

Gottesman

Hillis

et al. 2014

Stroke

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“…ESR has seldom been studied in patients on HD 19 . To the best of our knowledge, ESR has not previously been mentioned as a CV risk factor in this patient population.…”

Section: Discussionmentioning

confidence: 88%

Cardiac troponin I and beta 2 microglobulin as risk factors for early‐onset atherosclerosis in patients on haemodialysis

Zümrütdal¹,

Sezer²,

Demircan³

et al. 2005

Nephrology

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Section: Introductionmentioning

confidence: 99%

“…Since then, there have been only a few reports on the ESR in this population [3, 4, 5, 6]. All of them, except one [5], found that the Westergren ESR of 40 to 70 mm/h was markedly accelerated in HD patients compared with a top normal value of 25 mm/h [7]. However, none of these studies [1, 2, 3, 4, 5, 6]considered the fact that anemia, which accompanies renal failure, is one of the main factors responsible for accelerated ESR [8].…”

Section: Introductionmentioning

confidence: 99%

The Hematocrit-Corrected Erythrocyte Sedimentation Rate Can Be Useful in Diagnosing Inflammation in Hemodialysis Patients

Borawski

Myśliwiec

2001

Nephron

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Background/Aims: We aimed to determine predictors of erythrocyte sedimentation rate (ESR), and the ESR level pointing to the presence of inflammation in 60 chronic hemodialysis (HD) patients. Methods/Results: On bivariate analysis, increased Westergren ESR of 62 (4–160) mm/h correlated inversely with hematocrit (Hct) and serum albumin, and positively with age, plasma fibrinogen, serum C-reactive protein (CRP), immunoglobulins A and G, α₁-acid-glycoprotein and α₁-antitrypsin. On multivariable analysis, independent predictors of the ESR were raised CRP (p < 0.0001), low Hct (p < 0.0001), increased fibrinogen (p < 0.0001) and immunoglobulin A (p = 0.009), and older age (p = 0.015). The Hct-corrected ESR level [ESR × (Hct/45)] of 38 (4–91) mm/h was independently predicted by CRP (p < 0.0001), fibrinogen (p < 0.0001), and age (p = 0.001). In the patients with normal CRP and albumin, the Hct-corrected ESR value was normal (23 mm/h) and lower than that of 59 mm/h in the subjects with elevated CRP and hypoalbuminemia. Using these cut-off points, the positive and negative predictive values of the Hct-corrected ESR on the presence of inflammation were 1.0, and its sensitivity and specificity were 100%. Conclusion: Increased Westergren ESR in HD patients is associated with activated acute-phase response, anemia, and aging. The Hct-corrected ESR values of 23 and 59 mm/h precisely select the HD patients with severe inflammation from those without.

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Erythrocyte sedimentation rate, an underestimated tool in chronic renal failure

Cited by 23 publications

References 17 publications

Predicting Symptomatic Intracerebral Hemorrhage Versus Lacunar Disease in Patients With Longstanding Hypertension

Predicting Symptomatic Intracerebral Hemorrhage Versus Lacunar Disease in Patients With Longstanding Hypertension

Cardiac troponin I and beta 2 microglobulin as risk factors for early‐onset atherosclerosis in patients on haemodialysis

The Hematocrit-Corrected Erythrocyte Sedimentation Rate Can Be Useful in Diagnosing Inflammation in Hemodialysis Patients

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