**5. References**


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**14** 

*Spain* 

Olimpia Ortega

*Hospital Severo Ochoa, Leganés, Madrid* 

**Biomarkers in Chronic Kidney Disease -** 

**Ventricular Dysfunction and Overhydration** 

Since 1970s several studies have shown a significant prevalence of cardiovascular disease (CVD) among patients with end-stage renal disease (Linder et al., 1974). Among patients treated by hemodialysis and peritoneal dialysis, the prevalence of CVD is approximately 40%. Even after stratification by age, sex, race, and diabetes, CVD mortality in chronic kidney disease (CKD) patients is 10 to 20 times higher than in the general population (Foley et al., 1998). End-stage-renal-disease patients often have a high prevalence of cardiovascular risk factors as hypertension, diabetes and dyslipemia. Nevertheless, previous studies have shown that the high prevalence of CVD in hemodialysis patients is only partly explained by traditional risk factors (Cheung et al., 2000). Non-traditional risk factors have been emerged

in the last decade. One of this non-traditional risk factor is C-reactive protein (CRP).

In this chapter, it is tried to explain the results of several studies supporting an association between inflammation (measured by high levels of CRP), left-ventricular dysfunction and volume overload among patients with CKD and how volume overload, which is present at the very early stages of CKD, could be the main underlying factor contributing to the worse

**2. Inflammation (C-reactive protein) in patients with chronic kidney disease:** 

CRP is considered the prototypical acute-phase reactant in man. Plasma CRP is produced by

The plasma half-life of CRP is about 19 hours and is constant under all conditions of health and disease, so that the sole determinant of circulating CRP concentration is the synthesis rate, which thus directly reflects the intensity of the pathological process stimulating CRP production. In most disease, the circulating value of CRP reflects ongoing inflammation and/or tissue damage much more accurately than other laboratory parameters of the acutephase response. The CRP concentration is thus a very useful nonspecific biochemical marker of inflammation, measurement of which contributes importantly to screening for organic disease, monitoring of the response to treatment of inflammation and infection and

hepatocytes although other sites of local CRP synthesis have been suggested.

**1. Introduction** 

CV prognosis among these patients.

**prevalence and prognostic factor** 

detection of intercurrent infection (Pepys et al., 2003).

**The Linkage Between Inflammation,** 

Yavuz A, Ersoy FF, Passadakis PS, Tam P, Evaggelos DM, Katopodis KP, Ozener C, Akçiçek F, Camsari T, Ateş K, Ataman R, Vlachojannis GJ, Dombros NA, Utaş C, Akpolat T, Bozfakioğlu S, Wu G, Karayaylali I, Arinsoy T, Stathakis CP, Yavuz M, Tsakiris DJ, Dimitriades AC, Yilmaz ME, Gültekin M, Süleymanlar G & Oreopoulos DG. Phosphorus control in peritoneal dialysis patients. *Kidney Int Suppl*, Vol.108, (2008), pp. S152-158
