Serum C-reactive protein (CRP) in association with various nutritional parameters in maintenance hemodialysis patients.

Malnutrition and inflammation are common in hemodialysis (HD) patients, and are usually closely associated. Serum C-reactive protein (CRP) concentrations have been found to be significantly elevated in hemodialysis patients and reflects chronic inflammation, and as an acute-phase reactant, is a sensitive and independent marker of malnutrition. To investigate the association of serum CRP level with some nutritional variables in diabetic and non diabetic end-stage renal failure patients undergoing regular hemodialysis, we designed a study on 36 maintenance hemodialysis patients (f = 15, m = 21), consisting of 25 non-diabetic HD patients and 11 diabetic HD patients. In this study a near significant difference of CRP between diabetic and non-diabetics of all patients with more values of CRP in diabetics and a significant difference of CRP between diabetic and non-diabetics of female HD patients with more values in diabetics were seen. A significant difference of CRP between males and females of non-diabetic population with more values of CRP in males was found too. An inverse correlation of serum CRP with serum cholesterol and triglyceride levels and a near significant positive correlations of CRP with serum ALP and with serum intact parathormone (iPTH) were found too. An inverse correlation of serum CRP with dialysis efficacy was also seen. No significant association between serum CRP and serum albumin was seen. Compatible with some studies and in contrast to some other studies, the association of serum albumin with serum CRP levels in this study was insignificant. The positive correlation of high serum iPTH with inflammation implies further need to control hyperphosphatemia and secondary hyperparathyroidism in HD patients, also inverse correlation of serum CRP with cholesterol and triglyceride further support the malnutrition-inflammation complex syndrome (MICS) which frequently seen in hemodialysis patients (Tab. 3, Fig. 3, Ref. 42).