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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 1  |  Page : 323-328

C-reactive protein as a marker of pediatric hemodilaysis adequacy


1 Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Pediatrics, Abo Hammad Central Hospital, Sharkia, Egypt

Correspondence Address:
Tarek H Mohamed Afifi
Abo Hammad, Sharkia 173347
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_591_17

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Objective To compare the C-reactive protein (CRP) levels with the delivered dose of dialysis in terms of index of hemodialysis adequacy (Kt/V) in patients undergoing maintenance hemodialysis (HD). Background According to different studies, the target Kt/V should be 1.2 per session, while weekly Kt/V should be 4.5 for thrice-weekly HD patients to maintain adequate HD. Patients and methods This is a comparative, cross-sectional survey study. Patients who fulfilled the inclusion and exclusion criteria were enrolled in the present study. The delivered dose of HD, Kt/V was assessed by online clearance module (OCM) in Fresenius machines at the end of every session of dialysis and the weekly Kt/V was determined by adding all the three Kt/V values. On the other hand, serum CRP was determined after each session of HD. Both weekly Kt/V and CRP values were entered in a predesigned proforma. Results Of 30 patients on maintenance HD, high serum CRP level (>6 mg/dl) was found in nine patients. When the Kt/V was compared with the CRP level, there was a negative correlation between the two parameters (r = −0.4, P < 0.001). Low Kt/V means dialysis inadequacy, which is associated with CKD state, resulting in high CRP levels. Conclusion Low Kt/V means dialysis inadequacy, and is associated with chronic inflammatory state resulting in high CRP levels. To reduce the rate of morbidity and mortality, we concluded that the quality of life of dialysis patients can be improved by offering an adequate dose of HD reflected by Kt/V of at least 4.5 per week in all patients with end-stage renal disease.


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