Evaluation of Inflammatory Status in Chronic Kidney Disease Patients and a Comparison Between Hemodialysis and Peritoneal Dialysis Patients

Introduction Inflammation is a common denominator in patients with chronic kidney disease (CKD), which is not explained by the pre-morbid risk factors and can lead to atherosclerosis and increased cardiovascular mortality. We have compared inflammatory markers like high-sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in patients with CKD undergoing continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) in both pre-dialysis phase at baseline and post-dialysis phase at three months to determine which dialysis has a more inflammatory burden on the patient. Materials and methods Fifty CKD patients diagnosed with end-stage renal disease (ESRD) who fulfilled eligibility criteria were recruited in this prospective observational study over two years. We measured levels of IL-6, hs-CRP, serum albumin, and body mass index (BMI) in both pre-dialysis and post-dialysis phases. Our results were obtained by analyzing 50 patients of ESRD who were planned for renal replacement therapy in the form of bridge dialysis, out of which 25 were put on HD and CAPD each. Pre-dialysis assessment was done at baseline and post-dialysis at three months. Each group served as its own control. IL-6 and hs-CRP levels were performed using commercially available kits employing the enzyme-linked immunosorbent assay (ELISA) method. Results Inflammatory markers (hs-CRP, IL-6) were elevated in both the pre-dialysis and post-dialysis phases of CKD, regardless of the dialysis modality. hs-CRP was significantly elevated in the HD group as compared to the CAPD group; however, the difference in IL-6 between the two groups was not significant. Albumin and BMI were significantly low in both groups from baseline, with patients on HD exhibiting lower albumin than the CAPD group, although the result was insignificant. Conclusion Markers of inflammation, like hs-CRP and low albumin, are more pronounced in HD than in CAPD. We conclude that the inflammatory burden is higher in patients undergoing HD.