Biochemistry and Biomarkers of Inflamed Patients: Why Look, What to Assess
Abstract
Specific laboratory tests and physical findings are available to the practicing clinician that should raise the suspicion of inflammation. Inflammation is related to specific clinical outcomes. Once identified, changes in clinical practice may affect the level of inflammation in individual and or groups of dialysis patients with the hope that these changes may in turn affect outcome in a positive manner. Standard clinical tests and observations associated with inflammation are hypoalbuminemia, erythropoietin resistance, decreased iron saturation accompanied by high ferritin, frailty, low serum creatinine, reduced total and LDL-cholesterol, and increased C reactive protein (CRP). Inflammation is strongly associated with loss of physical function, dyslipidemia (low LDL- and HDL-cholesterol, increased triglycerides), and anemia that is unresponsive to erythropoietin. Inflammation is associated with cardiovascular events, increased hospitalization, and death. Correctible causes of inflammation are tunneled dialysis catheters, arteriovenous grafts, catheter infection, periodontal disease, poor water quality, and dialyzer incompatibility. Obesity also is a source of cytokines but may be less amenable to treatment. Inflammation is multifactorial in dialysis patients. Some sources are recognizable and correctable, such as vascular access type, clinical infection, and water quality, and some are not. Inflammation is strongly associated with outcome.
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More severe inflammation is associated with progressively lower serum albumin levels, although the strength of the correlation has only sparsely been investigated.
“More severe inflammation is associated with progressively lower serum albumin levels, although the strength of the correlation has only sparsely been investigated.23, 24”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [23]
In the Western world, the severity of inflammatory effects of comorbidity, obesity, lifestyle, organ failure, and aging leads to a proportional decrease in serum albumin levels.
“In the Western world, the severity of the inflammatory effects of comorbidity, obesity, lifestyle, organ failure, and aging lead to a proportional decrease in serum albumin levels.23, 76, 101, 102, 103, 104, 105, 106”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [23]
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- Authors
- Kaysen, G. A.
- Affiliations
- Veterans Health Administration (US)
- Corresponding author
- Kaysen, George A.
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2009-12
- Volume
- 4
- Issue
- Supplement_1
- Pages
- S56-S63
- ISSN
- 1555-9041 (ISSN-L)
- OpenAlex
- W2046022256
- Cited by
- 100
- References
- 103
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 5 · 2013: 5 · 2012: 9
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
- Keywords
- inflammation, dialysis patients, biomarkers, hypoalbuminemia, erythropoietin resistance, ferritin, C-reactive protein, dyslipidemia, anemia, cardiovascular events, vascular access, catheter-related infection, periodontal disease, water quality, obesity, frailty, physical function
- MeSH terms
- Renal Dialysis, Humans, Inflammation, Kidney Failure, Chronic, Predictive Value of Tests, Biomarkers, Prevalence, Treatment Outcome, Inflammation Mediators, Malnutrition
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