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 (hscrp), 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.