Reciprocal association of plasma adiponectin and serum C-reactive protein concentration in haemodialysis patients with end-stage kidney disease - A follow-up study

Aim: Malnutrition and inflammation are involved in the pathogenesis of atherosclerosis and increased risk of cardiovascular diseases in end-stage renal disease. The aim of this study was to assess the relationship between concentrations of plasma adiponectin, serum C-reactive protein (CRP), carotid intima-media thickness (IMT) and duration of haemodialysis (HD) treatment in prevalent HD patients. Methods: Plasma adiponectin and serum CRP concentrations were estimated in 80 HD patients and 22 healthy controls. Carotid IMT was measured by ultrasound technique. HD patients were followed up for 23 16 months. During this period, 24 of them died. Results: In HD patients, plasma adiponectin concentration was over 3 times higher than in controls (29.0 +/- 2.1 vs. 8.7 +/- 2.6 mu g/ml; p < 0.001). HD patients with serum CRP concentrations >= 5 mg/l were characterized by a lower plasma adiponectin concentration than HD patients with the CRP <5 mg/l (23.9 +/- 3.5 vs. 33.0 +/- 3.1 mu g/ml; p = 0.03). Plasma adiponectin and serum CRP concentrations were inversely related in HD (tau = -0.181; p = 0.02). No relationship between adiponectinaemia and IMT was observed. Survival (Kaplan-Meier analysis) within the lowest plasma adiponectin tertile tended (p = 0.06) to be the worse. Conclusions: (1) Inflammatory processes are associated with an inadequate low plasma adiponetin concentration in HD patients, and (2) a lower plasma adiponectin concentration seems to be a new predictor of poor outcome in HD patients. Copyright (C) 2005 S. Karger AG, Basel.