Reciprocal Association of Plasma Adiponectin and Serum C-Reactive Protein Concentration in Haemodialysis Patients with End-Stage Kidney Disease - A Follow-Up Study

摘要

Aim: Malnutrition and inflammation are involved in the pathogenesis of atherosclerosis and increased risk of cardiovascular diseases in end-stage renal disease. The aim of this study was to assess the relationship between concentrations of plasma adiponectin, serum C-reactive protein (CRP), carotid intima-media thickness (IMT) and duration of haemodialysis (HD) treatment in prevalent HD patients. Methods: Plasma adiponectin and serum CRP concentrations were estimated in 80 HD patients and 22 healthy controls. Carotid IMT was measured by ultrasound technique. HD patients were followed up for 23 +- 16 months. During this period, 24 of them died. Results: In HD patients, plasma adiponectin concentration was over 3 times higher than in controls (29.0 +- 2.1 vs. 8.7 +- 2.6 (xg/ml; p < 0.001). HD patients with serum CRP concentrations>5 mg/l were characterized by a lower plasma adiponectin concentration than HD patients with the CRP <5 mg/l (23.9 +- 3.5 vs. 33.0 +-3.1 fig/ml; p = 0.03). Plasma adiponectin and serum CRP concentrations were inversely related in HD (t = -0.181; p = 0.02). No relationship between adiponectinaemia and IMT was observed. Survival (Kaplan-Meier analysis) within the lowest plasma adiponectin tertile tended (p = 0.06) to be the worse. Conclusions: (1) Inflammatory processes are associated with an inadequate low plasma adiponetin concentration in HD patients, and (2) a lower plasma adiponectin concentration seems to be a new predictor of poor outcome in HD patients.