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Three-month variation of plasma pentraxin 3 compared with C-reactive protein, albumin and homocysteine levels in haemodialysis patients.

Sjöberg B, Snaedal S, Stenvinkel P, Qureshi AR, Heimbürger O, Bárány P - Clin Kidney J (2014)

Bottom Line: The variation was calculated as the intra-class correlation (ICC).PTX-3 measurements are less stable and show higher variation within patients than CRP, albumin and Hcy.Persistently elevated PTX-3 levels are associated with high mortality.

View Article: PubMed Central - PubMed

Affiliation: Division of Renal Medicine , CLINTEC, Karolinska Institutet , Stockholm , Sweden.

ABSTRACT

Background: Inflammatory markers vary considerably over time in haemodialysis (HD) patients, yet the variability is poorly defined. The aim of the study was to assess changes of plasma levels of pentraxin-3 (PTX-3), C-reactive protein (CRP), albumin and homocysteine (Hcy) over 3 months and the association between the changes in these biomarkers and mortality.

Methods: In 188 prevalent HD patients, inflammatory markers were measured at inclusion and after 3 months. Mortality was recorded during a median follow-up of 41 months. The changes of the biomarker levels were categorized according to change in tertile for the specific biomarker. The variation was calculated as the intra-class correlation (ICC). Mortality was analysed by Kaplan-Meier and Cox proportional hazards model. The predictive strength was calculated for single measurements and for the variation of each inflammatory marker.

Results: The intra-individual variation (low ICC) was largest for PTX-3 [ICC 0.44; 95% confidence interval (CI): 0.33-0.55], albumin (ICC 0.58; 95% CI: 0.49-0.67) and CRP (ICC 0.59; 95% CI: 0.51-0.68) and lowest for Hcy (ICC 0.81; 95% CI: 0.77-0.86). During follow-up, 88 patients died.

Conclusions: PTX-3 measurements are less stable and show higher variation within patients than CRP, albumin and Hcy. Persistently elevated PTX-3 levels are associated with high mortality. Moreover, in multivariate logistic regression we found that stable high PTX-3 adds to the mortality risk, even after inclusion of clinical factors and the three other biomarkers. The associations of decreasing albumin levels as well as low Hcy levels with worse outcome reflect protein-energy wasting.

No MeSH data available.


Related in: MedlinePlus

Variance components for PTX-3, CRP, albumin and Hcy in HD patients. The ICC was calculated from estimates of between-subjects and within-subjects derived from mixed models.
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SFU071F1: Variance components for PTX-3, CRP, albumin and Hcy in HD patients. The ICC was calculated from estimates of between-subjects and within-subjects derived from mixed models.

Mentions: From the variation of PTX-3, CRP, albumin and Hcy, the ICC was calculated and the within-subject variation was most pronounced for PTX-3 having the lowest ICC (44%). Hcy had the highest ICC (81%), indicating that most of the observed variability in a given assay is explained by between-subject variation, implying greater stability within individual patients upon repeated measurements over time. In contrast, the low ICC of PTX-3 implies that the within-subject variation is high and that repeated measurements in the same individuals over time will yield more disparate results (Figure 1).Fig. 1.


Three-month variation of plasma pentraxin 3 compared with C-reactive protein, albumin and homocysteine levels in haemodialysis patients.

Sjöberg B, Snaedal S, Stenvinkel P, Qureshi AR, Heimbürger O, Bárány P - Clin Kidney J (2014)

Variance components for PTX-3, CRP, albumin and Hcy in HD patients. The ICC was calculated from estimates of between-subjects and within-subjects derived from mixed models.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4377816&req=5

SFU071F1: Variance components for PTX-3, CRP, albumin and Hcy in HD patients. The ICC was calculated from estimates of between-subjects and within-subjects derived from mixed models.
Mentions: From the variation of PTX-3, CRP, albumin and Hcy, the ICC was calculated and the within-subject variation was most pronounced for PTX-3 having the lowest ICC (44%). Hcy had the highest ICC (81%), indicating that most of the observed variability in a given assay is explained by between-subject variation, implying greater stability within individual patients upon repeated measurements over time. In contrast, the low ICC of PTX-3 implies that the within-subject variation is high and that repeated measurements in the same individuals over time will yield more disparate results (Figure 1).Fig. 1.

Bottom Line: The variation was calculated as the intra-class correlation (ICC).PTX-3 measurements are less stable and show higher variation within patients than CRP, albumin and Hcy.Persistently elevated PTX-3 levels are associated with high mortality.

View Article: PubMed Central - PubMed

Affiliation: Division of Renal Medicine , CLINTEC, Karolinska Institutet , Stockholm , Sweden.

ABSTRACT

Background: Inflammatory markers vary considerably over time in haemodialysis (HD) patients, yet the variability is poorly defined. The aim of the study was to assess changes of plasma levels of pentraxin-3 (PTX-3), C-reactive protein (CRP), albumin and homocysteine (Hcy) over 3 months and the association between the changes in these biomarkers and mortality.

Methods: In 188 prevalent HD patients, inflammatory markers were measured at inclusion and after 3 months. Mortality was recorded during a median follow-up of 41 months. The changes of the biomarker levels were categorized according to change in tertile for the specific biomarker. The variation was calculated as the intra-class correlation (ICC). Mortality was analysed by Kaplan-Meier and Cox proportional hazards model. The predictive strength was calculated for single measurements and for the variation of each inflammatory marker.

Results: The intra-individual variation (low ICC) was largest for PTX-3 [ICC 0.44; 95% confidence interval (CI): 0.33-0.55], albumin (ICC 0.58; 95% CI: 0.49-0.67) and CRP (ICC 0.59; 95% CI: 0.51-0.68) and lowest for Hcy (ICC 0.81; 95% CI: 0.77-0.86). During follow-up, 88 patients died.

Conclusions: PTX-3 measurements are less stable and show higher variation within patients than CRP, albumin and Hcy. Persistently elevated PTX-3 levels are associated with high mortality. Moreover, in multivariate logistic regression we found that stable high PTX-3 adds to the mortality risk, even after inclusion of clinical factors and the three other biomarkers. The associations of decreasing albumin levels as well as low Hcy levels with worse outcome reflect protein-energy wasting.

No MeSH data available.


Related in: MedlinePlus