HDCN Article Review/Hyperlink

Brouillard M, Reade R, Boulanger E, Cardon G, Dracon M, Dequiedt P, Pagniez D

Erythrocyte sedimentation rate, an underestimated tool in chronic renal failure

Nephrol Dial Transplant (Nov) 11:2244-2247 1996

The erythrocyte sedimentation rate (ESR) is used in non-uremic patients to evaluate the course of a variety of inflammatory disorders. It is strongly affected by the plasma fibrinogen level, alphaglobulins, and hematocrit. The ESR has been reported to be quite elevated in ESRD patients in 2 previous papers, that questioned its utility in this population. With the recent interest in occult inflammation, elevated inflammatory markers such as C-reactive protein and TNF in dialysis patients with hypoalbuminemia, it is conceivable that the utility of the ESR has been understated.

In this paper, Brouillard et al found that the ESR was only mildly elevated in 45 ESRD patients with a mean Hct of 25%. Median ESR was only 30 mm/h, compared to values of 60 and 70 mm/h in two previous studies by other investigators. ESR was positively correlated with serum fibrinogen level, and negatively with the hematocrit, as expected.

Comment: The study is interesting in that it partially refutes observations of two previous studies, in which a marked ESR elevation was found. The "utility" of the ESR in ESRD patients still needs to be demonstrated. (John T. Daugirdas, M.D., University of Illinois at Chicago)

The full text of this abstract is available from Oxford Press at this site.