الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
The prevalence of chronic kidney disease (CKD) is rising, especially in elderly. Half of patients initiating dialysis are over 65 years. The Estimated glomerular filtration rate (eGFR) for half of people over 70 is less than 60 mL/min/1.73 m2.
Inflammation is linked to the pathophysiology and progression of CKD, some studies documented significantly elevated level of inflammatory markers between patients with CKD. Also, this elevated level of inflammatory markers, as C-reactive protein (CRP), Interleukin-6 (IL-6) and Tumor necrosis factor alpha (TNF-α), is a feature of aging, which now termed as inflammaging, characterized by systemic low-grade inflammation.
CRP is an acute-phase protein which is released by hepatocyte under stimulation of several inflammatory cytokines. Recently, CRP was recognized to play an active role in atherogenesis, causing high risk for arterial diseases through endothelial dysfunction. TNF alpha is a proinflammatory cytokine produced by monocytes and macrophages that was related to tumor regression, and cachexia. TNF has a several impacts on the body, including changes in lipid metabolism, coagulation, and endothelial dysfunction. IL6 is a pleiotropic cytokine that plays a part in the immune and inflammatory response. Emerging data showed IL-6 promotes the progression of CKD by exacerbating renal damage and by aggravating its complications.
This study aimed to assess the association of CRP, TNF-alpha, and IL-6 with CKD in elderly.
The study was conducted at Alexandria Main University Hospital, Geriatric unit, or Outpatient Clinics. It included 80 subjects aged 65 years or older divided into 40 CKD patients and 40 controls, CKD was defined as eGFR <60 ml/min/1.73 m2 or the presence of albuminuria (≥30 mg/24-h) for three or more months. All patients included in the study were subjected to history taking, clinical examination, ultrasound renal assessment and laboratory investigations such as CBC, urea, creatinine, urine analysis, Urinary albumin /creatinine ratio, Electrolytes, lipid Profile, virology, Serum levels of hs-CRP, Serum levels of TNF-α and Serum levels of IL-6. eGFR was calculated using 2021 CKD-EPI Creatinine Equation.
Our study found that there was a statistically significant association of CRP, TNF-alpha, and IL-6 with CKD in elderly.
Univariate regression analysis showed that Hypertension, hs-CRP, TNF-alpha and IL-6 are significantly associated with CKD with (p=0.025), (p< 0.001), (p=0.004) and (p=0.002) respectively In a multivariate regression analysis, we found that inflammatory markers including CRP, TNF alpha and IL-6 were still significantly elevated in elderly patients with CKD, with p<0.001, p=0.010 and p=0.006 respectively independent of established risk factors as CVD, DM and HTN. Further longitudinal studies are needed to confirm the causality of inflammatory markers in the incidence and progression of CKD in elderly.