Clinical significance of single and persistent elevation of serum high-sensitivity C-reactive protein levels for predict
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ORIGINAL ARTICLE
Clinical significance of single and persistent elevation of serum high‑sensitivity C‑reactive protein levels for prediction of kidney outcomes in patients with impaired fasting glucose or diabetes mellitus Lili Liu1,2,3,4 · Bixia Gao1,2,3,4 · Jinwei Wang1,2,3,4 · Chao Yang1,2,3,4 · Shouling Wu5 · Yuntao Wu5 · Shuohua Chen6 · Qiuyun Li7 · Huifen Zhang8 · Guodong Wang5 · Min Chen1,2,3,4 · Ming‑hui Zhao1,2,3,4,9 · Luxia Zhang1,2,3,4,10 Received: 21 November 2019 / Accepted: 18 August 2020 © Italian Society of Nephrology 2020
Abstract Background The association between high-sensitivity C-reactive protein (hs-CRP) and chronic kidney disease remains controversial and long-term longitudinal studies are limited. We aim to investigate the impact of single and persistent elevation of hs-CRP on kidney outcomes. Methods Our study was based on a subgroup of patients with hyperglycemia from the Kailuan cohort. Patients were divided into three groups according to two consecutive hs-CRP levels: (1) no elevation (twice hs-CRP 5 mmHg, then the third measurement was conducted and the average of the three readings was used. Serum samples were collected in the morning after an overnight fast and serum creatinine, FBG, lipid profile (including total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) were tested using a Hitachi 7600 auto-analyzer (Hitachi; Tokyo, Japan). Estimated glomerular filtration rate (eGFR) was calculated using the two-race CKD Epidemiological Collaboration equation [17]. A single mid-stream morning urine sample was collected from each participant. Urine protein concentration was assessed by dry chemistry method
Patients with IFG or diabetes in 2006, n=30,016
History of cancer at baseline, n=74 Lost to follow-up, n=2128
Missing data of CRP in 2006 or 2008, n=8997 History of ESKD in 2006 or 2008, n=60
Patients included into analysis, n=18,757 Patients with missing data of proteinuria at
Patients with missing data of eGFR at
baseline or during follow-up, n=3530
baseline or during follow-up, n=92 1) For kidney function decline, n=18,665
Patients with overt-proteinuria in 2006 or 2008, n=685
Patients without overt-proteinuria, n=14,542 Patients with micro-proteinuria in 2006 or 2008, n=2788 2) For incidence of proteinuria Patients without proteinuria, n=11,754
Patients without proteinuria in 2008, n=12,832 3) For progression of proteinuria Patients with micro-proteinuria, n=1710
Fig. 1 Flow chart of the study population
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with the test assay of H12-MA (Changchun Dirui Medical Technology Co., Ltd. Changchun, China). All the urine samples were measured using a urine analyzer (N-600, Dirui, Changchun, China) at the central laboratory of the Kailuan Hospital. The levels of the semi-quantitative dipstick test were recorded as negative, trace, 1 +, 2 +, or 3 +. We further defined micro-proteinuria as urine dipstick reading trace or 1 + and overt-proteinuria as urine dipstick reading ≥ 2 + [18].
Measurement of hs‑CRP and definiti
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