Serum C-reactive protein and thioredoxin levels in subjects with mildly reduced glomerular filtration rate

The subjects were 182 participants of a health check-up program including those with normal (≥ 90 mL/min/1.73 m2, N = 79) and mildly reduced eGFR (60-89 mL/min/1.73 m2, N = 103) which was calculated based on serum creatinine, age and sex. We excluded those with reduced eGFR < 60 mL/min/1.73 m2. No one had proteinuria. We measured serum levels of C-reactive protein (CRP) and thioredoxin (TRX) as the markers of inflammation and oxidative stress, respectively.As compared with subjects with normal eGFR, those with mildly reduced eGFR had increased levels of both CRP and TRX. Also, eGFR was inversely correlated with these biomarkers. The associations of eGFR with these biomarkers remained significant after adjustment for age and sex. When adjustment was done for eight possible confounders, CRP showed significant association with systolic blood pressure, high density lipoprotein cholesterol (HDL-C) and non-HDL-C, whereas TRX was associated with sex significantly, and with eGFR and systolic blood pressure at borderline significance.We showed the increased levels of CRP and TRX in subjects with mildly reduced eGFR. The eGFR-CRP link and the eGFR-TRX link appeared to be mediated, at least partly, by the alterations in blood pressure and plasma lipids in these subjects.Chronic kidney disease (CKD) is a newly recognized high-risk population for cardiovascular disease (CVD) [1]. The relative risk of death from myocardial infarction is 10-30 times higher in hemodialysis patients (CKD stage 5D) as compared to the general population [2]. Atherosclerotic vascular changes are present in patients with CKD not yet treated with hemodialysis [3-5] as well as in hemodialysis patients [6]. The risk for CVD increases in a stepwise manner as glomerular filtration rate (GFR) declines [7]. The increased risk of CVD in reduced GFR may be explained at least partly by impairment of classical risk factors including hypertension [8], dyslipidemia [9], and glucose intolerance/insulin resistance [10