Relationship between high-sensitivity C-reactive protein/albumin ratio and catheter-related infection in maintenance hemodialysis patients

Huo Yuanyuan; Zhang Shaomei; He Yao; Liu Rongli; Tang Yuan; Lu Jinhua; Gao Ya; Chen Chen; Yan Jie

doi:10.11986/j.issn.1673-873X.2024.11.06

Abstract：Objective To explore the relationship between the high-sensitivity C-reactive protein/albumin(hs-CRP/Alb)rati-o and cathetcr-rclated infection in maintenance hemodialysis(MHD)patients,aiming to provide new ideas and basis for clin-ical risk assessment and the development of individualized treatment strategies.Methods A total of 144 MHD patients trea-ted at a hospital in Xi'an from January 2020 to December 2023 were selected as the study participants and allocated to an in-fection group(n=30)and a non-infection group(n=114)based on the absence or presence of catheter infection.General information and laboratory test indicators were collected from all participants,and the hs-CRP/Alb ratio was calculated at admission.The changes in hs-CRP,Alb,and hs-CRP/Alb were analyzed in the two groups of patients,as well as their val-ue in assessing catheter-related infections in MHD patients.Multivariate logistic regression models were used to analyze the influencing factors of catheter-related infection in MHD patients.Results The levels of hs-CRP and hs-CRP/Alb were sig-nificantly higher in the infection group than in the non-infection group,while the level of Alb was significantly lower(P＜0.05).The area under the curve(AUC)(95％CI)for assessing catheter-related infection in MHD patients using hs-CRP,Alb,and hs-CRP/Alb were 0.792(0.747-0.842),0.740(0.690-0.785),and 0.921(0.876-0.971),respectively.No significant differences were noted in gender,age,body mass index(BMI),course of the disease,primary disease,alcohol consumption,smoking,proportion of patients with hypertension,and red blood cell count levels between the two groups(P＞0.05).The proportion of patients with catheter dwell time ≥30 days,femoral vein catheterization,diabetes mellitus,and white blood cell count ≥10X 109/L were significantly higher in the infection group than in the non-infection group(P＜0.05).Multivariate logistic regression analysis showed catheter dwell time ≥30 days(OR=2.601,95％CI:1.422-4.757),femoral vein catheterization(OR=2.115,95％CI:1.268-3.257),and hs-CRP/Alb ≥0.9(OR=4.419,95％CI:2.034-9.604)were risk factors for catheter-related infection in MHD patients(P＜0.05).Conclusion The hs-CRP/Alb ratio is closely related to catheter-related infection in MHD patients and can serve as a powerful indicator for infection risk assessment.