Highly sensitive C-reactive protein, pentraxin-3 and mannose-binding lectin in patients with hemodialysis and their association with cardiovascular complications and mortality

Abstract

Introduction: Cardiovascular disorder(CVD) is one of the most important comorbidities in patients with hemodialysis(HD). Several markers for kidney disease and kidney transplantation have been investigated. Objectives: This study aimed to evaluate the association between three inflammatory biomarkers including C-reactive protein (CRP), pentraxin 3 (PTX-3) and mannose-binding lectin (MBL) with CVD events and mortality in HD patients. Patients and Methods: This study was carried on patients with immunosuppressive therapy aged between 18-80 years with chronic renal failure undergoing HD. Patients were visited at baseline and every six month for 12 months. The levels of biomarkers and complications were recorded before, one week later and 2 months after transplantation. Echocardiography and calculation of ejection fraction(EF) were performed to determine the occurrence of CVD events. Results: Ninety patients with the mean age of 54.0±3.24 years were included. All biomarkers had significant area under the curve for accurate diagnosis between the patients with low EF (with a decreasing measure) and normal EF patients (p<0.05); however, none of them had a significant accurate diagnosis between patients with low EF (with a constant measure) and normal EF patients (P>0.05). PTX-3 and MBL showed a significant correlation to detect CVD events (r=0.987; p<0.0001). Also, PTX-3 and MBL had significant correlations with hs-CRP (P<0.05). None of these markers had significant accuracy for prediction of mortality. Conclusion: Serum level of PTX-3 and MBL not only increase reactive protein, but also may be considered as diagnostic biomarkers for early detection of CVD events in patients with end stage renal disorders.