eISSN: 2345-2781  
Submitted: 10 Sep 2017

Accepted: 08 Sep 2018
First published online: 03 Feb 2018
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J Renal Inj Prev. 2018;7(4):286-291.
doi: 10.15171/jrip.2018.63

Original Article

Association between CA-125, ESR, and high-sensitive C-reactive protein and cardiac function in hemodialysis patients

Nahid Azdaki, Zeinab Saremi * , Zahra Tanaki

1 Department of Internal Medicine, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Introduction: Inflammation plays an important role in the pathogenesis of cardiovascular diseases in patients receiving hemodialysis.

Objectives: To compare serum levels of quantitative as high-sensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), and cancer antigen 125 (CA-125) among three groups including hemodialysis with heart failure (HF), hemodialysis without HF and healthy controls.

Patients and Methods: Seventy patients with chronic kidney disease (CKD) receiving hemodialysis were included. Thirty-five healthy subjects were in the control group. Inflammatory markers were measured. All subjects underwent 2D transthoracic echocardiography. HF was defined as LVEF (left ventricular ejection fraction) <50%.

Results: ESR and hs-CRP levels, but not CA-125, were significantly higher in hemodialysis group versus control group. Median (IQR) ESR was significantly higher in hemodialysis group with systolic HF ([16.50 [17]) and without systolic HF (15.50 [21]) compared to control group (8 [7]); P<0.001. Likewise, median (IQR) hs-CRP was higher in hemodialysis with HF (9 [3]) and without HF (9 [5]) than in control group (4[2]); P<0.001. The Mann-Whitney U tests did not show any statistically significant difference within hemodialysis group between those with and without HF regarding ESR (P=0.81) or hs-CRP (P=0.76). However, median (IQR) CA-125 value was significantly higher in hemodialysis with systolic HF group (23.20 [25.04]) compared to hemodialysis without systolic HF (11.40 [8.91]); P=0.003.

Conclusion: ESR and hs-CRP levels are increased among ESRD patients on hemodialysis regardless of the presentence of HF. However, CA-125 was the only marker which showed a significant increase in the presence of HF. CA-125 needs further studies to determine its role in follow-up and prognosis of CKD patients with systolic HF.

Implication for health policy/practice/research/medical education:

Hemodialysis patients are at greater risk of developing cardiovascular diseases. Inflammation has a major role in this condition. Inflammatory markers erythrocyte sedimentation rate (ESR) and high-sensitive C-reactive protein (hs-CRP) rise significantly in hemodialysis patients. This finding is regardless of the presence or absence of systolic heart failure (HF). On the other hand, cancer antigen 125 (CA-125) is a marker that is higher when systolic HF is present in hemodialysis patients.

Please cite this paper as: Azdaki N, Saremi Z, Tanaki Z. Association between CA-125, ESR, and high-sensitive C-reactive protein and cardiac function in hemodialysis patients. J Renal Inj Prev. 2018;7(4):286-291. DOI: 10.15171/jrip.2018.63.

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