#2987 Describing inflammatory markers in end-stage renal disease and hemodialysis

Abstract

Abstract Background and Aims There is an increased inflammatory state in patients with End-Stage Renal Disease (ESRD). It is crucial to investigate if the decline in renal function influences on the levels of infectious and inflammatory parameters, particularly procalcitonin (PCT) which exhibits the highest specificity for bacterial infections. Additionally, it would be useful establish a PCT cut-off-value for patients on renal replacement therapy and ESRD in the absence of infection, facilitating the differentiation between those with and without bacterial infection. The aim of this study is to analyze infectious and inflammatory parameters, including PCT, in ESRD and HD patients. A secondary objective is to explore the link among inflammatory markers between themselves and with some specific clinical conditions. Method A cross-sectional observational comparative study was conducted involving HD patients (Group 1) and ESRD (Group 2). We assessed PCT, C-Reactive Protein (CRP), Sedimentation Velocity (SV), and Ferritin, among others. Patients with active infection were excluded. For HD patients, analytical extraction was conducted before the midweek session. Results are presented as mean ± standard deviation for variables exhibiting a normal distribution, and as the median for variables displaying a non-normal distribution. Normality was assessed using the Shapiro-Wilk test. Group comparisons were conducted using Mann Whitney test for variables with a non-normal distribution. Relationships between parameters were examined using the Spearman correlation test and linear regression analysis. Significance was established at p < 0.05. The statistical software utilized was Jamovi (Version 2.3). Results We found in HD patients (Group 1) when compared to ESRD patients (Group 2) higher PCT levels, higher ferritin levels, and lower albumin levels, with statistical significance (Table 1). Conclusion There is a decrease in albumin levels and an increase in PCT, and ferritin levels in HD patients compared to ESRD patients. We observed that RCP, and ferritin were independent predictive factors of PCT levels, but, unexpected, diabetes was not. Given the fact that ESRD, and HD patients are in a chronic inflammatory status, it is difficult to assess the acute infectious severity in these patients. For that reason, the cut-off-values of inflammatory parameters in these patients in a non-infectious time-point needs to be clarified.