Course of C-reactive protein during continuous peritoneal dialysis-associated peritonitis

Objective:  C-reactive protein (CRP) levels increase during peritonitis. Little is known about the extent and duration of CRP elevation.

Patients and Methods:  Patients on continuous peritoneal dialysis (CPD) therapy had a baseline CRP value at the start of the study. CRP values were determined at 48 h, 2 weeks and 4 weeks after an episode of peritonitis developed in the 13 months after the study started.

Results:  The demographic values and comorbid diseases of the patients developing and not developing peritonitis were not significantly different. Patients who developed peritonitis had a mean ± SD CRP value of 15.0 ± 11.1 mg/L compared with 15.7 ± 9.9 mg/L in patients without peritonitis. The CRP value rose to 118.35 ± 96.86 mg/L at 48 h, and decreased to 34.5 ± 43.6 mg/L at 2 weeks and to 30.1 ± 39.7 mg/L at 4 weeks after the onset of peritonitis. All types of peritonitis were associated with a significant increase in CRP at 48 h. Nine patients had CRP elevations above baseline at 4 weeks; seven patients had active medical issues.

Conclusion:  CRP values become significantly elevated during peritonitis. Most patients have a decrease in the CRP values toward baseline values at 4 weeks following the onset of peritonitis while 20% of patients had continued elevations. The significance of the elevations is unclear. Given the associations of CRP with cardiovascular mortality in both uremic and non-uremic patients and the association of peritonitis with mortality, the role of this inflammatory marker deserves further evaluation.