Relationship Among Pentraxin3,High Sensitive C-Reactive Protein And Malnutrition In Hemodialysis Patients Of Old Age

Objective:Maintenance hemodialysisi(MHD)is a major method for kidney replacement therapy in patients who have end stage disease,however,the results of such therapy are far from satisfactory.There are micro-inflammation and malnutrition in people taking MHD,which is more serious in old ones.Meanwhile,micro-inflammation and malnutrition affect each other.People with micro-inflammation and malnutrition are prone to die and have a bad prognosis.Currently,high sensitivity c-reactive protein(hs-CRP)is a common marker used to test micro-inflammation.Pentraxin-3 has a close link with inflammation.In this article,we talked about relationship between PTX3,hs-CRP and malnutrition.Method:1.Subject:There were 81 patients undergoing MHD therapy with effective urea clearnance time/volume(Kt/V)>1.2.There were 61 patiens over 60 years old while 20 patients less than 60.2.General information of patients included age,gender,primary disease and condition of inflammation.3.Laboratory indicators and parameter settings:To measure serum albumin(Alb),serum creatinine(Scr),hemoglobin(HB).ELISA was used to test PTX3,while immune turbidimmetric method was used to test serum levels of high sensitive C creative protein(hs-CRP).To adopt the single compartment model Kt/V as an evaluation index of dialysis adequacy in MHD patients.Subject nutritional assessment(SGA)including weight and intake was used as evaluation of the nutritional status of patients.4.Statistical methods:Measurement data was shown with (?),while the comparison was conducted with t test.X~2 test conducted measurement data.The bivariate correction analysis was measured with Spearman rank correlation analysis or Pearson linear correlation analysis.Results:1.General data: There were 81 patients in this study,including 41 men and 40 women.While there was no statistically significant difference in gender and Kt/V between two groups.2.Inflammation data:PTX3(3.09±1.19 OD450)and hs-CRP(5.52±3.09 mg/L)in old MHD patients were higher than PTX3(2.24±0.90 OD450)and hs-CRP(4.01±2.19 mg/L)in the other group.3.Nutritional data: There was a higher level of SGA in old MHD patients.However,the level of Scr(707.31 ± 267.82 mmol/L)and Alb(37.27±4.53 g/L)in old MHD patients were lower than Scr(997.80±137.88 mmol/L)and Alb(41.92±2.77 g/L)in another group.4.Comparison of correlation:the value of PTX3 in old patients was positively relative with hs-CRP(r=0.524,P<0.05)and SGA(r=0.417,P<0.05),while negatively with ALB(r=-0.479,P<0.05).By controlling sex,age and BMI,comparison of partial correlation:the value of PTX3 in old patients was positively correlated with hs-CRP(r=0.532,P<0.05)and SGA(r=0.401,P<0.05),while negatively with ALB(r=-0.492,P<0.05).5.The predictive analysis of PTX3 activity and hs-CRP serum levels on malnutrition in MHD patients: Hs-CRP was used to predict malnutrition in old MHD patients,which was statistically significant different from SGA(P<0.05).On the contrary,there was no difference in PTX3 and SGA predicting malnutrition in old MHD patients(P>0.05).Conclusion:1.Micro-inflammation and malnutrition are common in MHD patients.2.Micro-inflammation and malnutrition in old MHD patients are more serious than others.3.PTX3 is positively corrected with hs-CRP,thus having ability to predict malnutrition in old MHD patients.4.PTX3 may be a better marker to predict malnutrition in old MHD patients.