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Licensed Unlicensed Requires Authentication Published by De Gruyter August 1, 2009

Anti-citrullinated protein antibody and rheumatoid factor in patients with end-stage renal disease

  • Zeljko Romic , Adriana Unic , Lovorka Derek , Marcela Zivkovic , Domagoj Marijancevic , Petar Kes and Mario Pehar


Background: Patients with end-stage renal disease (ESRD) and on hemodialysis (HD) are at increased risk for developing rheumatoid arthritis (RA), as a result of defective immunity. Our aim was to examine if ESRD and the length of HD treatment impact the clinical utility of antibodies to cyclic citrullinated peptides (anti-CCP) and rheumatoid factor (RF) as diagnostic tools for RA.

Methods: We included 94 subjects in our study: 37 healthy volunteers and 57 patients with ESRD who had been undergoing HD for 1–12 years, and without confirmed RA. In order to test our hypothesis, we measured and correlated anti-CCP and RF as laboratory markers of RA.

Results: Our study showed that there is no significant difference between values for anti-CCP (p=0.11) and RF (p=0.98) in control subjects as well as in patients undergoing HD, regardless of the length of time that patients had been undergoing HD treatment.

Conclusions: Our study indicates that HD does not impair the specificity of anti-CCP and RF for RA in patients where the disease has not yet developed. Future prospective studies may show whether there is any use in determinating RF, and especially anti-CCP, as early predictors of RA in patients with ESRD who are at greater risk of developing this condition.

Clin Chem Lab Med 2009;47:959–62.

Corresponding author: Adriana Unic, BSc in Medical Biochemistry, Department of Laboratory Diagnostics, Dubrava University Hospital, Avenija Gojka Šuška 6, HR-10 000 Zagreb, Croatia Phone: +385-1-290-3356,

Received: 2009-2-16
Accepted: 2009-5-6
Published Online: 2009-08-01
Published in Print: 2009-08-01

©2009 by Walter de Gruyter Berlin New York

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