Correlation analysis between serum hs CRP/Alb ratio and cardiovascular events in maintenance hemodialysis patients with end-stage renal disease

Tong Wei; Huang Qifeng; Jiang Xiaowei; Liu Ping; Yang Zhuo

doi:10.3969/j.issn.1671-6450.2023.12.012

Abstract：Objective To analyze the correlation between serum high sensitivity C-reactive protein/albumin(hs CRP/Alb)ratio and cardiovascular events in maintenance hemodialysis(MHD)patients with end-stage renal disease(ESRD).Methods One hundred and sixty-four ESRD MHD patients admitted to the Nephrology Department of the 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from May 2019 to February 2022 were selected.Based on the occurrence of cardiovascular events within one year of the patient's MHD,they were divided into a group of 103 patients without cardiovascular events and a group of 61 patients with cardiovascular events.Measure the patient's blood pressure and laboratory indicators before the first dialysis after admission,and calculate the hs CRP/Alb ratio.Pearson method was used to analyze the correlation between serum hs CRP/Alb ratio and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)in ESRD MHD patients;Multivariate logistic regression analysis was conducted to determine the risk factors for cardiovascular events in ESRD pa-tients within one year after receiving MHD treatment;The value of analyzing the working characteristics(ROC)curve of subjects in predicting cardiovascular events in ESRD patients within 1 year after receiving MHD treatment,including serum hs CRP,Alb,and hs CRP/Alb ratios.Results Compared with the group without cardiovascular events,the levels of TG,TC,LDL-C,hs CRP,and hs CRP/Alb in the cardiovascular event group were significantly increased(t/P=5.810/＜0.001,12.888/＜0.001,16.735/＜0.001,6.186/＜0.001,19.997/＜0.001),while the levels of HDL-C and Alb were significantly reduced(t/P=13.751/＜0.001,8.714/＜0.001);The serum hs CRP/Alb ratio in ESRD MHD patients was positively correlated with TG,TC,and LDL-C(r/P=0.472/0.017,0.581/＜0.001,0.673/＜0.001),and negatively correlated with HDL-C(r/P=-0.622/＜0.001);High levels of hs CRP and hs CRP/Alb ratio are both risk factors for cardiovascular events in ESRD patients within one year after receiving MHD treatment[OR(95％CI)=3.563(1.309-9.700),1.822(1.179-2.815)];The areas under the curve(AUC)predicted by high serum hs CRP,low Alb,high hs CRP/Alb ratio,and the combination of these three factors for cardiovas-cular events in ESRD patients within 1 year after receiving MHD treatment were 0.843,0.829,0.924,and 0.961,respectively.The AUC predicted by the combination of these three factors was higher than that predicted separately(Z/P=3.383/＜0.001,3.681/＜0.001,1.635/＜0.001).Conclusion The elevated serum hs CRP/Alb ratio in ESRD MHD patients with cardiovascular events is a risk factor that affects the occurrence of cardiovascular events one year after MHD treatment,and has certain predictive value for the occurrence of cardiovascular events.