C-Reactive Protein and Uric Acid as Prognostic Biomarkers in Chronic Renal Failure: A Hemodialysis-Based Study from Kerbala, Iraq

Abstract

Background: Chronic kidney disease (CKD) is an important health problem especially in low resource settings with limited access to sophisticated diagnostic facilities. Biochemical and inflammatory parameters, such as creatinine, urea, uric acid, and CRP, might serve as available alternatives for monitoring of the disease.

Methods: A case–control study was carried out at Al-Sadr Medical City, Kerbala, Iraq, comprising 39 hemodialysis patients and 30 gender- and age-matched healthy controls with chronic renal failure. Serum creatinine, urea, uric acid and CRP levels were determined by standard biochemical methods. The CO25 threshold was determined with receiver-operator curves (ROC) analysis, using SPSS software (version 26) and determining the sensitivity and specificity as well as area under the curve (AUC(

Results: The hemodialysis patients had a significantly higher mean level of creatinine (3.04 ± 1.60 mg.dL-1), urea (178.7 ± 96.0 mg.dL-1), uric acid (8.28 ± 3.39 mg.dL-1), and CRP (20.34 ± 2.17 mg.L-1) than the controls (p < 0.001). There was a strong positive correlation between CRP and uric acid (r = 0.542, p = 0.002) and between CRP and urea (r = 0.54, p = 0.003), while urea correlated with BMI and age (p ≤ 0.005). ROC analysis showed a very good diagnostic accuracy (AUC/0.97–1.00) for all biomarkers, of which CRP and uric acid were essentially informative predictors.

Conclusion: The results emphasize the interplay between inflammatory and metabolic biomarkers in CKD. High CRP and uric acid not only reflect renal function, but also independently predict cardiovascular outcomes. The integration of these low-cost biomarkers in routine care of dialysis patients may aid in stratifying risk among Iraqi patients. These associations need to be verified by larger, prospective studies.