BACKGROUND/AIMS: Several inflammatory biomarkers have been found to be associated with cardiovascular disease or all-cause mortality in dialysis patients, but their usefulness in clinical practice or as surrogate endpoints is not certain. The purpose of the present study was to determine the intrapatient variation of C-reactive protein, IL-6, fetuin-A and albumin in a population of dialysis patients. METHODS: Apparently healthy dialysis patients with either a tunneled dialysis catheter or fistula had monthly assessments of these biomarkers for a total of four determinations, and the intraclass correlation coefficients were calculated as measures of intersubject variance. RESULTS: Our results showed large within-subject variation relative to the total variation in the measurements (31-46%). Having a tunneled catheter as opposed to a fistula was not significantly associated with mean levels, suggesting that chronic subclinical catheter infection does not explain the variation seen in the biomarkers. In contrast, there was a rapid change in these biomarkers with a clinically apparent acute infection. CONCLUSION: These results suggest that these biomarkers have limitations for use as surrogate endpoints in clinical trials due to wide fluctuations, even in apparently clinically healthy individuals. Copyright 2008 S. Karger AG, Basel.
BACKGROUND/AIMS: Several inflammatory biomarkers have been found to be associated with cardiovascular disease or all-cause mortality in dialysis patients, but their usefulness in clinical practice or as surrogate endpoints is not certain. The purpose of the present study was to determine the intrapatient variation of C-reactive protein, IL-6, fetuin-A and albumin in a population of dialysis patients. METHODS: Apparently healthy dialysis patients with either a tunneled dialysis catheter or fistula had monthly assessments of these biomarkers for a total of four determinations, and the intraclass correlation coefficients were calculated as measures of intersubject variance. RESULTS: Our results showed large within-subject variation relative to the total variation in the measurements (31-46%). Having a tunneled catheter as opposed to a fistula was not significantly associated with mean levels, suggesting that chronic subclinical catheter infection does not explain the variation seen in the biomarkers. In contrast, there was a rapid change in these biomarkers with a clinically apparent acute infection. CONCLUSION: These results suggest that these biomarkers have limitations for use as surrogate endpoints in clinical trials due to wide fluctuations, even in apparently clinically healthy individuals. Copyright 2008 S. Karger AG, Basel.
Authors: Markus Ketteler; Philipp Bongartz; Ralf Westenfeld; Joachim Ernst Wildberger; Andreas Horst Mahnken; Roland Böhm; Thomas Metzger; Christoph Wanner; Willi Jahnen-Dechent; Jürgen Floege Journal: Lancet Date: 2003-03-08 Impact factor: 79.321
Authors: Markus Ketteler; Christoph Wanner; Thomas Metzger; Philipp Bongartz; Ralf Westenfeld; Ulrich Gladziwa; Leon J Schurgers; Cees Vermeer; Willi Jahnen-Dechent; Jürgen Floege Journal: Kidney Int Suppl Date: 2003-05 Impact factor: 10.545
Authors: Anne van Tellingen; Muriel P C Grooteman; Margreet Schoorl; Piet C M Bartels; Marianne Schoorl; Tjeerd van der Ploeg; Piet M ter Wee; Menso J Nubé Journal: Kidney Int Date: 2002-08 Impact factor: 10.612
Authors: M P de Maat; A C de Bart; B C Hennis; P Meijer; A C Havelaar; P G Mulder; C Kluft Journal: Arterioscler Thromb Vasc Biol Date: 1996-09 Impact factor: 8.311