The Influence Of Different Dialysis Modes And Length On CRP For Patients With Chronic Renal Failure

Objective To explore the influence of different dialysis modes and lengths on inflammatory status for uremic patients , by observing the changes of serum c-reactive protein (CRP) levels in non-dialysis patients, hemodialysis (HD) patients and peritoneal dialysis (PD) patients,all with chronic renal failure (CRF).Methods 96 patients, specifically 41 hemodialysis patients, 35 peritoneal dialysis patients, and 20 non-dialysis uremia patients were included in this study along with 20 controls.Fasting venous bloods from patents and controls were tested for the concentrations of c-reactive protein (CRP), creatinine (Scr), urea nitrogen (BUN), albumin (ALB), hemoglobin (Hb), parathyroid hormone (PTH), plasma lipids (cholesterol CH, triglyceride TG, high-density lipoprotein cholesterol HDL-C, low density lipoprotein LDL - C), uric acid UA, calcium Ca, phosphorus P, serum iron Fe, etc. CRP was used as inflammatory index, Scr, Ccr, BUN, ALB, Hb, PTH, CH, TG, HDL-C, LDL - C, UA, Fe, Ca, P, Ca×P, blood pressure, age and gender, etc were used as relevant factors for analysis. The differences between each group were compared. Meanwhile, the difference of CRP levels between hemodialysis (HD) patients and peritoneal dialysis (PD) patients after different dialysis length were analyzed.Results (1) CRP level in HD group, PD group and the non-dialysis group with chronic renal failure (uremia period) were showed significantly higher than those in the normal controls, P < 0.05 with significant difference. CRP levels in both HD group and PD group were lower than those in the non-dialysis group, but there was no statistical difference wtihthin the two patient groups (P > 0.05). (2) HD group with 1 year of dialysis had lower CRP levels than those in HD group with 2 years of dialysis, with statistical difference (P < 0.05). There was no statistical difference between PD group with 1 year of dialysis and PD group with 2 years of dialysis (P > 0.05). (3) no matter in which group,CRP level showed no linear correlation with Ccr and Scr level (P < 0.05), but had linear correlation with Hb, Fe, TG and systolic blood pressure (P < 0.05). (4) ALB level in PD patients showed significantly lower than that in HD patients, and malnutrition was more evident in PD patients compared with HD patients. Conclusion 1. HD group, PD group and the non-dialysis group with Chronic renal failure (uremia period) showed significantly higher CRP levels than the controls. Patients with chronic renal failure (uremia stage) are in the state of chronic inflammation, characterized by elevated CRP. CRP level in patients in the uremia stage has no correlation with creatinine clearance and serum creatinine. 2. In 2 years by dialysis, the length of dialysis in hemodialysis patients have positive correlation with CRP level; the longer dialysis is performed, the higher CRP levels. The length of dialysis in peritoneal dialysis doesn't have association with CRP level. 3. CRP levels in uremic patients is negatively correlated with Hb, Fe level; the more serious anemia is, the more serious inflammation state is. This type of anemia has some relationship with iron-deficiency anaemia.