Original investigation: pathogenesis and treatment of kidney disease and hypertensionRelationship between C-reactive protein, albumin, and cardiovascular disease in patients with chronic kidney disease
Section snippets
Methods
Details of the MDRD study have been published previously.18 In brief, it was a randomized, controlled trial of 840 patients with predominantly nondiabetic kidney disease and reduced GFR, conducted between 1988 and 1993, to study the effects of dietary protein restriction and strict blood pressure control on the progression of kidney disease. All patients entering baseline had mean arterial pressures of 125 mm Hg or less, were 18 to 70 years of age, and had chronic kidney disease with serum
Results
Mean age of the 801 participants of the MDRD Study randomized cohort included in this study was 52 ± 12 (SD) years. Sixty percent were men, and the prevalence of non-insulin-dependent diabetes was 5%. Minimum and maximum GFRs were 12 to 55 mL/min/1.73 m2, with a mean GFR of 32.7 ± 12.0 mL/min/1.73 m2. Frozen samples were not available for 39 of the original 840 participants in the MDRD Study. There was no difference in age, sex, BMI, percentage of body fat, albumin level, and prevalence of
Discussion
In summary, in this large group of subjects with reduced GFR, CRP levels approximate those in the general population. As in patients with kidney failure, there appears to be an association between CRP level with both nutritional indices and CVD. However, GFR level does not appear to be related to CRP level in the MDRD Study randomized cohort.
There is increased inflammatory activity with concomitant activation of the acute-phase response in patients on dialysis therapy.4, 33, 34 Levels of CRP,
Acknowledgements
The authors acknowledge the help of Frederick Van Lente, PhD, of the Cleveland Clinic in aliquotting and maintaining frozen samples.
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Supported in part by grants no. 1 K23 DK02904-02 and UO1 DK 35073 from the National Institute of Diabetes and Digestive and Kidney Diseases; National Kidney Foundation of Massachusetts, Rhode Island, New Hampshire, and Vermont, Inc; and Dialysis Clinic, Inc.