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.