Derangement in Serum Inflammatory Biomarkers Among Patients with End Stage Renal Disease

Abstract

Background: End stage renal disease is an important public health problem. Renal replacement therapy, dialysis and transplantation are used to provide relief from the symptoms of end stage renal disease whilst also preserving the life of the patients though they are not curative. Haemodialysis is the widely used method although it produces a negative impact on quality of life of the patients. Hypoalbumianemia has been reported to be frequently present in haemodialysis patients and correlates strongly with mortality and morbidity. Objective: To determine the frequency of deranged  inflammatory biomarkers in patients with end stage renal disease on hemodialysis, in Nishtar Hospital Multan. Material and methods: One hundred thirty-one cases with ESRD were selected from Hemodialysis Department, Nishtar Hospital Multan and  3ml of venous blood sample was taken before starting a session of hemodialysis and sent to central laboratory of Nishtar Hospital Multan. Serum Albumin was obtained by an automatic analyzer, and serum CRP by slide test, free of cost, to measure deranged inflammatory biomarkers. Data was analyzed by using SPSS version 20. Results: Of these 131 study cases, 85 (64.9%) were male patients while 46 (35.1%) were female patients. Mean age of our study cases was 42.37 ± 5.98 years. Of these 131 patients with ESRD on hemodialysis 33 (25.2%) were diabetic, 65 (49.6%) were hypertensives and 13 (9.9%) were obese. Mean duration on hemodialysis was 19.51 ± 7.59 months, 80 (61.1%) had to undergo hemodialysis twice a week and 51 (38.9%) had to undergo three times a week. Mean serum albumin level was noted to be 3.37 ± 0.59 g/dl. Mean serum C-reactive protein level was noted to be 20.73 ± 15.84 mg/l. Frequency of deranged inflammatory biomarkers in our study was noted to be in 109 (83.2%) of the study cases. Conclusion: Very high frequency of derangement in inflammatory biomarkers have been noted in our study. This derangement in these inflammatory biomarkers was significantly associated with female gender, increasing age, increased duration on hemodialysis and increased frequency of hemodialysis. The early diagnosis of these derangements followed by preventive measures can help decrease disease morbidity and mortality among targeted population.

Keywords: Inflammatory biomarkers, deranged, end-stage renal disease, hemodialysis.