Abstract: Objective  To investigate the value of serum C-reactive protein (CRP)/albumin (ALB), interleukin-22 (IL-22) and heparin binding protein (HBP) for the early prediction of infection in chronic renal failure (CRF) patients undergoing hemodialysis.  Methods  A total of 113 CRF patients undergoing hemodialysis in Chengdu Sixth People's Hospital from January 2021 to June 2023 were selected as the research subjects. They were divided into an infection group (26 cases) and a non-infection group (87 cases) based on whether they had an infection in hospital within 6 months of dialysis. The levels of serum CRP/ALB, IL-22 and HBP were compared between the two groups, and the value of serum CRP/ALB, IL-22 and HBP levels for the prediction of infection in CRF patients undergoing hemodialysis were then analyzed.  Results  In the infection group, the levels of serum CRP, CRP/ALB, IL-22 and HBP were higher (t=3.880, 5.228, 5.454 and 5.246 respectively; P<0.001) and the level of ALB was lower (t=5.291, P<0.001) as compared those with the non-infection group. Serum CRP/ALB, IL-22 and HBP were positively correlated with the infection probability score (IPS) (r=0.811, 0.791 and 0.826 respectively; 95% CI：0.704～0.935, 0.683～0.917 and 0.718～0.951 respectively; P<0.001). The area under the curve (AUC) of serum CRP/ALB, IL-22 and HBP for predicting infection in CRF patients undergoing hemodialysis were 0.752 (95% CI: 0.662～0.828), 0.811 (95% CI: 0.727～0.879), and 0.800 (95% CI: 0.714～0.869) respectively. The risk of infection in the patients with positive expression of serum CRP/ALB, IL-22 and HBP was 4.232 times (95% CI: 2.158～8.299), 5.854 times (95% CI: 2.558～13.395) and 6.049 times (95% CI: 2.803～13.056) respectively, higher than that in the patients with negative expressions (all P<0.001). The AUC of combined serum CRP/ALB, IL-22 and HBP to predict infection in the patients was 0.927 (95% CI: 0.863～0.968), greater than the AUCs of the three indicators separately (Z=2.565, 2.435 and 2.079 respectively; P=0.010, 0.015 and 0.038 respectively), with the sensitivity of 88.46% and the specificity of 80.46%.  Conclusion  Serum CRP/ALB, IL-22 and HBP are significantly correlated with the possibility of concurrent infection in CRF patients undergoing hemodialysis. They can effectively predict the risk of infection, especially when combination of the three indicators is used for the prediction.

Key words: Chronic renal failure, Hemodialysis, C-reactive protein/albumin, Interleukin-22, Heparin-binding protein