Relationship between microinflammatory state of end-stage renal disease and anemia, malnutrition, left ventricular function in maintenance hemodialysis patients
10.3760/cma.j.issn.1008-6315.2010.08.021
- VernacularTitle:终末期肾脏病维持性血液透析患者微炎症与贫血和营养不良及左心室功能的关系
- Author:
Yingjie LI
- Publication Type:Journal Article
- Keywords:
Uremia;
Hemodialysis;
Microinflammatory status;
Malnutrition;
Anemia;
Left ventricle
- From:
Clinical Medicine of China
2010;26(8):840-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study microinflammatory status in patients of end-stage renal disease undergoing maintained hemodialysis (MHD) and the relationship between microinfl-ammatory status of end-stage renal disease and anemia, malnutrition, left ventricular function in maintained hemodialysis patients. Methods One hundred patients undergoing hemodialysis were divided into non-microinflammation group ( hs-CRP ≤ 3 mg/L) and microinflammation group ( hs-CRP > 3 mg/L) . The serum levels of hs-CRP, albumin, triglyceride ( TG) , total cholesterol(TC) , lipoprotein(a) [LP( a)] and serum creatinine ( SCr) were measured. The levels of hemoglobin (Hb) and hematocrit (Hct) were measured. The left atrial (LAD)and ventricular diameter(LVD) ,interventricular septum thickness (IVST) ,left ventricular posterior wall thickness (LVPW) ,left ventricular ejective fraction (EF), ratio of E/A were measured by color Doppler echocardiography, and left ventricular mass index (LVMI) was calculated. Blood pressure was measured in different 5 stages, and their relation were analysed. Results ①The levels of Hb, Hct, Alb in microinflammation group were lower than those in the control group(t =2. 83 ,P <0.01; t=2.34, P<0.05;t = 5.30,P <0.01, respectively), the level of LP(a) was higher than that in the non-microinflammation group(t = 2. 68, P < 0. 05 ). ②The levels of LAD, LVD, LVPW, IVST, LVMI in the elevated microinflammation group were higher than those in the control group (P < 0.05), the levels of EF and E/A were lower than those in the non-microinflammation group ( P < 0. 05 ) .③ Blood serum hs-CRP concentration was negatively correlated with the level of Hb,Hct(r= -0. 283,P <0. 05;r = -0. 308,P <0.05;r = -0.387,P< 0. 01, respectively ) , and positively correlated with LP ( a ) ( r = 0.427, P < 0. 05 ) . Blood serum hs-CRP concentration was positively correlated with LVD,IVST,LVMI (P <0. 05) and negatively correlated with EF,E/A (P<0.05). ④hs-CRP, Hb, Hct, Kt/V, Alb, Lp(a) ,SBP and PP were risk factors of abnormal left ventricular structure and function. Conclusions In patients undergoing maintenance hemodialysis, the persistent increase of hs-CRP indicates the presence of microinflammation hs-CRP might.be a indicator of the anemia, nutrition status and left ventricular structure and function. Elevated hs-CRP is an independent risk factor of abnormal left ventricular structure and function.
