Perez Valdivieso JR, Bes-Rastrollo M, Monedero P, Olaondo LL, de Irala J, Lavilla FJ.Serum C-reactive protein on the prognosis of oncology patients with acute renal failure: an observational cohort study.Arch Med Res. 2008 Apr;39(3):326-331.
We undertook this study to evaluate the significance of the C-reactive protein level (CRP) as a prognostic factor in oncology patients with acute renal failure (ARF) during nephrology consultation. METHODS: The study was
comprised of a cohort of 375 consecutive oncology patients who had been admitted
to a university-affiliated hospital between March 1998 and April 2006 and had
been diagnosed with ARF. One hundred and fifty nine patients with ARF who matched
at least one of the RIFLE criteria on increased serum creatinine were included
for subsequent analysis. We used a Cox proportional hazard model. RESULTS:
Clinical pathological variables were compared among patients with serum CRP
levels > or =8 mg/dL (exposed group; cut-off point: median) and patients with
serum CRP level <8 mg/dL (control group). In-hospital mortality rates associated
with CRP levels were 53.8% for > or =8 mg/dL and 21.5% for <8 mg/dL (p <0.001).
After adjusted analysis, the presence of a CRP level > or =8 mg/dL was
significantly associated with an increased in-hospital mortality (HR 2.10; 95%
CI: 1.17-3.78) than in those patients with similar Liano scoring, the same RIFLE
classes, and the same treatment for ARF. In addition, each increment of 1 mg/dL
of serum CRP was associated with an adjusted 4% increment of in-hospital
mortality (HR 1.04, 95% CI: 1.01-1.06). CONCLUSIONS: CRP levels at nephrology
consultation were an independent predictor of death in this cohort of oncology
patients with ARF. Patients with levels > or =8 mg/dL may be considered at higher
risk of death.