Relationship Between Biomarkers Of Mineral And Bone Disorder And C-Reactive Protein In Maintenance Hemodialysis Patients

Objective:Both mineral and bone disorder and inflammation are closely related to long-term outcomes in maintenance hemodialysis patients. Our study aimed to investigate the association of biomarkers of mineral and bone disorder with C-reactive protein level.Methods:A cross-sectional study of 215 maintenance hemodialysis patients, aged (53.1±15.7) years, were enrolled from a single tertiary care center. Serum high-sensitivity C-reactive protein (hsCRP) is as the marker of inflammation, and biomarkers of mineral and bone disorder, including serum calcium, serum phosphorus and intact parathyroid hormone (iPTH), were measured and compared with the recommended range in the KDIGO guidelines. The correlations between hsCRP and the biomarkers of mineral and bone disorder were analyzed.Results:Only 54 patients met the recommended range in the KDIGO guidelines. The group which achieved the guideline range had lower hsCRP levels(4.5mg/L vs 7.3mg/L, P<0.05). The serum hsCRP level was significantly related to serum phosphorus (r＝0.170, P<0.05), negatively related to hemoglobin (r=-0.152, P<0.05), and serum albumin (r=-0.158, P<0.05). Multiple stepwise regression analysis revealed that serum phosphorus and serum albumin were independently associated with hsCRP. Logistic regression analysis using the presence/absence of an inflammatory state as the dependent variable, showed that serum phosphorus was an independent risk factor, whereas serum albumin is a protective factor for the presence of an inflammatory state.Conclusion:There is a strong association between chronic inflammation and the disturbance of mineral and bone disorder in maintenance hemodialysis patients. Serum phosphorus was an independent risk factor for the presence of an inflammatory state, which suggests elevated serum phosphorus may play an important role in the development of inflammation in maintenance hemodialysis patients.