| Persistent elevation of C-reactive protein and ischemic heart disease in patients with continuous ambulatory peritoneal dialysis. | |
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MedLine Citation:
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PMID: 11840375 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We evaluated the association between a persistent elevation of C-reactive protein (CRP) level and the presence or severity of ischemic heart disease (IHD) in patients with continuous ambulatory peritoneal dialysis (CAPD). Seventy-three patients, who were over 40 years old, underwent dipyridamole thallium single photon emission computed tomography (SPECT), and followed-up for more than 1 year were enrolled. We measured stored plasma for CRP every 3 months. Elevation of CRP was defined as greater than or equal to 5 mg/L and persistent elevation of CRP as elevated CRP levels that lasted longer than 6 months. Serum albumin, cholesterol, lipoprotein(a), and plasma fibrinogen were measured at 3 months after the start of CAPD. Twenty-six patients showed an elevation of CRP for more than 6 months during the follow-up period. Twenty-eight patients showed positive findings on thallium SPECT. Coronary angiography showed significant stenosis (narrowing of the diameter more than 50%) in 23 of the 25 patients studied. Seventeen (65%) of 26 patients who had an elevated CRP level for longer than 6 months had positive thallium SPECT. The presence of diabetes, albumin, fibrinogen, and the presence of a persistent elevation of CRP were different between the patients with positive (n = 28) or negative thallium SPECT (n = 45). A multivariate logistic regression analysis showed that a persistent elevation of CRP is the only predictor of positive thallium SPECT (P = 0.002). There was a tendency of association, although it was not statistically significant, between the persistence of CRP elevation and the severity of IHD (P = 0.066). Three of 9 patients who had a persistent elevation of CRP and a negative thallium SPECT had a history of cerebral infarction or peripheral vascular disease. Therefore, 77% (20/26) of an elevated CRP level that lasted longer than 6 months can be explained by the presence of IHD or other atherosclerotic vascular disease. In conclusion, a persistent elevation of CRP level in patients with CAPD was strongly associated with IHD. For patients who have a persistent elevation of CRP without an apparent cause, we recommend a workup for IHD or other atherosclerotic cardiovascular disease. |
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Authors:
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Soon Bae Kim; Won Ki Min; Sang Koo Lee; Jung Sik Park; Changgi D Hong; Won Seok Yang |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 39 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-02-12 Completed Date: 2002-03-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 342-6 Citation Subset: IM |
Copyright Information:
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Copyright by the National Kidney Foundation, Inc. |
Affiliation:
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Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood C-Reactive Protein / analysis* Female Follow-Up Studies Humans Male Middle Aged Multivariate Analysis Myocardial Ischemia / blood, diagnosis*, epidemiology* Peritoneal Dialysis, Continuous Ambulatory / statistics & numerical data* Thallium / diagnostic use Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 7440-28-0/Thallium; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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