ERYTHROCYTE SEDIMENTATION-RATE, AN UNDERESTIMATED TOOL IN CHRONIC-RENAL-FAILURE

Background, Erythrocyte sedimentation rate is widely used in the gener al population. It has seldom been studied in patients with chronic ren al failure. The purpose of this study was to assess its usefulness in haemodialysis patients. Methods. Forty-five haemodialysis patients wit h no evidence of acute or chronic inflammatory illness were studied. N ine were diabetic, and 12 used a non-biocompatible membrane. Erythrocy te sedimentation rate was determined, using a modified Westergren meth od. Plasma fibrinogen concentration, complete blood count, and serum c hemistries were also studied. Results. Erythrocyte sedimentation rate was normal or mildly elevated in most of our patients, with a median o f 30 mm/h. Linear analysis found positive correlation between erythroc yte sedimentation rate and fibrinogen concentration, globulin level, p latelet, and white cell counts, and negative correlation with haematoc rit. Fibrinogen concentration was normal in 22 patients, and moderatel y elevated in 14. It was significantly higher in diabetic patients, or those using a non-biocompatible membrane. The same positive correlati ons were found for fibrinogen concentration as for erythrocyte sedimen tation rate. Conclusions. We conclude that erythrocyte sedimentation r ate can be used in haemodialysis patients much in the same way as in t he general population, as it is influenced by the same factors, and it s baseline value is lower than previously reported. The lower concentr ation of fibrinogen, an independent predictor of cardiovascular risk, in patients treated with biocompatible membranes may be of clinical re levance.