PMID- 12768072
OWN - NLM
STAT- MEDLINE
DCOM- 20030820
LR  - 20061115
IS  - 1121-8428 (Print)
IS  - 1121-8428 (Linking)
VI  - 16
IP  - 2
DP  - 2003 Mar-Apr
TI  - Inflammation, infection and cardiovascular events in chronic hemodialysis 
      patients: a prospective study.
PG  - 245-51
AB  - BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and 
      mortality in chronic hemodialysis (HD) patients. Inflammation is a potent risk 
      factor for CV disease in the general population. Recent evidence suggests 
      infection, particularly with agents such as Chlamydia pneumoniae (C.pneumoniae) 
      and Helicobacter pylori (H.pylori), as a source of sustained inflammation. Our 
      study tested the hypothesis that C-reactive protein (CRP) and positive serology 
      for antibodies to C.pneumoniae and H.pylori can be associated with the occurrence 
      of new CV events in chronic HD patients. METHODS: We evaluated 76 chronic HD 
      patients (33 women and 43 men, aged 60.5+/-17.3 years) by measuring baseline CRP 
      levels as well as the titres of antibodies (IgG and IgA) to C.pneumoniae and(IgG) 
      to H.pylori. In addition, risk factors such as hypertension, smoking, diabetes, 
      cholesterol levels and albumin were assessed at baseline. The incidence of new CV 
      events (myocardial infarction and ischemic stroke) was recorded during a 36-month 
      follow-up period. The effect of prognostic factors was evaluated by logistic 
      regression analysis. RESULTS: The incidence of CV events was significantly higher 
      in patients seropositive for C.pneumoniae antibodies than in those seronegative 
      (16.1 vs. 4.3 events/100 patient-years, p=0.017, risk ratio 3.76), whereas it did 
      not differ for H.pylori (12.2 vs. 11.7 events/100 patient-years,p=0.91, risk 
      ratio 1.04). Logistic regression analysis showed C.pneumoniae seropositivity 
      (odds ratio 10.11, p=0.04) and CRP levels (odds ratio 1.78, p=0.03) to be 
      independent predictors of the occurrence of CV events. CONCLUSIONS: CRP levels 
      and C.pneumoniae antibodies, but not H.pylori antibodies, were predictors of CV 
      morbidity in the chronic HD patients studied.
FAU - Bellomo, Gianni
AU  - Bellomo G
AD  - Nephrology and Dialysis Unit, Assisi Hospital, Assisi, Italy. assidial@tin.it
FAU - Lippi, Giorgio
AU  - Lippi G
FAU - Saronio, Paolo
AU  - Saronio P
FAU - Reboldi, Giampaolo
AU  - Reboldi G
FAU - Verdura, Claudio
AU  - Verdura C
FAU - Timio, Francesca
AU  - Timio F
FAU - Timio, Mario
AU  - Timio M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Italy
TA  - J Nephrol
JT  - Journal of nephrology
JID - 9012268
SB  - IM
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Cardiovascular Diseases/diagnosis/*epidemiology
MH  - Chlamydophila Infections/diagnosis/*epidemiology
MH  - Cohort Studies
MH  - Comorbidity
MH  - Female
MH  - Helicobacter Infections/diagnosis/*epidemiology
MH  - Helicobacter pylori/isolation & purification
MH  - Humans
MH  - Incidence
MH  - Inflammation/diagnosis/epidemiology
MH  - Kidney Failure, Chronic/diagnosis/*epidemiology/*therapy
MH  - Long-Term Care
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Probability
MH  - Prognosis
MH  - Prospective Studies
MH  - Renal Dialysis/*methods
MH  - Risk Assessment
MH  - Sex Distribution
MH  - Statistics, Nonparametric
MH  - Survival Rate
EDAT- 2003/05/28 05:00
MHDA- 2003/08/21 05:00
CRDT- 2003/05/28 05:00
PHST- 2002/09/23 00:00 [received]
PHST- 2003/03/18 00:00 [accepted]
PHST- 2003/03/07 00:00 [revised]
PHST- 2003/05/28 05:00 [pubmed]
PHST- 2003/08/21 05:00 [medline]
PHST- 2003/05/28 05:00 [entrez]
PST - ppublish
SO  - J Nephrol. 2003 Mar-Apr;16(2):245-51.