Study of High-sensitivity C-reactive Protein Levels in Chronic Kidney Disease Patients on Maintenance Hemodialysis and Evaluating Immediate Impact of Hemodialysis on hs-CRP Levels: A Prospective Case–Control Study

Aim and background: Chronic kidney disease (CKD) is associated with elevated levels of inflammation, contributing significantly to cardiovascular complications, particularly in patients undergoing maintenance hemodialysis (MHD).High-sensitivity C-reactive protein (hs-CRP) is a wellestablished marker of inflammation and cardiovascular risk.This study aimed to compare baseline serum hs-CRP levels in CKD stage 5D patients and assess the immediate effect of hemodialysis (HD) on hs-CRP levels in those on MHD.Objectives include comparing pre-and post-dialysis hs-CRP levels with baseline values of controls. Materials and methods:A prospective case-control study was conducted at a tertiary care hospital in Mumbai over 18 months.Fifty end-stage renal disease (ESRD) patients undergoing thrice-weekly HD and 50 age-and gender-matched healthy controls were included.Serum hs-CRP levels were measured in pre-and post-HD samples from patients and compared with controls.Data were analyzed using paired and unpaired student's t-tests.Results: High-sensitivity CRP levels were significantly higher in both pre-HD (66.24 55.34 mg/L) and post-HD (70.93 59.82 mg/L) samples compared to controls (1.38 0.40 mg/L, p < 0.001).However, the difference in hs-CRP levels between pre-and post-HD groups (4.69 mg/L, p = 0.685) was not statistically significant. Conclusion:This study confirms significantly elevated hs-CRP levels in CKD stage 5D patients on MHD, reflecting chronic inflammation and metabolic alterations.While HD effectively reduces urea and creatinine, it does not significantly change inflammation in the short term.Persistently high hs-CRP may be due to dialysis frequency, prolonged treatment, socioeconomic factors, dialyzer reuse, and malnutrition-inflammation complex syndrome (MICS).Clinical significance: The study underscores the persistent inflammatory state in CKD patients on maintenance HD.It highlights the need for routine hs-CRP monitoring to assess cardiovascular risk and suggests that HD alone does not mitigate systemic inflammation and emphasizes the importance of adjunct therapies and personalized interventions to address inflammation.