Background: The aim of this study was to evaluate whether a high baseline level of high-sensitivity C-reactive\r\nprotein (hs-CRP) or changes in the level predicts the risk of peritonitis in patients on continuous ambulatory\r\nperitoneal dialysis (CAPD).\r\nMethods: A prospective, cross-sectional, caseââ?¬â??control study was conducted in a single hospital-based PD unit. A\r\ntotal of 327 patients were included in the study. Serum hs-CRP was measured annually for 2 years. Patients were\r\ndivided into 4 groups according to the changes in annual hs-CRP levels (at baseline and at 1 year intervals): group\r\n1 (from <5 mg/L to <5 mg/L, n = 171), group 2 (from <5 mg/L to =5 mg/L, n = 45), group 3 (from =5 mg/L to <5\r\nmg/L, n = 45), and group 4 (from =5 mg/L to =5 mg/L, n = 80). Demographics, biochemistry results, PD adequacy\r\nindices, and peritonitis risk were compared between the groups.\r\nResults: The initial serum albumin level was similar in the 4 groups (p = 0.12). There was a negative linear\r\ncorrelation between the serial albumin change (?alb) and serial hs-CRP change (?hs-CRP; r = -0.154, p = 0.005). The\r\nhazard ratio (HR) for peritonitis was significantly higher in group 2 (HR = 1, reference) than in group 4 (HR = 0.401,\r\n95% CI 0.209 - 0.769). Group 2 had a greater serum albumin decline rate (?alb: ââ?¬â??3% Ã?± 9%) and hs-CRP elevation\r\nrate (?hs-CRP: 835% Ã?± 1232%) compared to those for the other groups.\r\nConclusions: A progressive increase in the hs-CRP level was associated with a corresponding decline in the serum\r\nalbumin level. Progressive rather than persistently high levels of serum hs-CRP predicted peritonitis risk in CAPD patients.
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