Association between CA-125, ESR, and high-sensitive C-reactive protein and cardiac function in hemodialysis patients

Introduction: Inflammation plays an important role in the pathogenesis of cardiovascular diseases in patients receiving hemodialysis. Objectives: To compare serum levels of quantitative as high-sensitive C-reactive protein (hs- CRP), erythrocyte sedimentation rate (ESR), and cancer antigen 125 (CA-125) among three groups including hemodialysis with heart failure (HF), hemodialysis without HF and healthy controls. Patients and Methods: Seventy patients with chronic kidney disease (CKD) receiving hemodialysis were included. Thirty-five healthy subjects were in the control group. Inflammatory markers were measured. All subjects underwent 2D transthoracic echocardiography. HF was defined as LVEF (left ventricular ejection fraction) <50%. Results: ESR and hs-CRP levels, but not CA-125, were significantly higher in hemodialysis group versus control group. Median (IQR) ESR was significantly higher in hemodialysis group with systolic HF ([16.50 [17]) and without systolic HF (15.50 [21]) compared to control group (8 [7]); P < 0.001. Likewise, median (IQR) hs-CRP was higher in hemodialysis with HF (9 [3]) and without HF (9 [5]) than in control group (4[2]); P < 0.001. The Mann-Whitney U tests did not show any statistically significant difference within hemodialysis group between those with and without HF regarding ESR (P = 0.81) or hs-CRP (P = 0.76). However, median (IQR) CA-125 value was significantly higher in hemodialysis with systolic HF group (23.20 [25.04]) compared to hemodialysis without systolic HF (11.40 [8.91]); P = 0.003. Conclusion: ESR and hs-CRP levels are increased among ESRD patients on hemodialysis regardless of the presentence of HF. However, CA-125 was the only marker which showed a significant increase in the presence of HF. CA-125 needs further studies to determine its role in follow-up and prognosis of CKD patients with systolic HF.