Utility of Traditional Circulating and Imaging-Based Cardiac Biomarkers in Patients with Predialysis CKD
Key result
Cardiac biomarkers may be used for prognostication in non-dialysis-dependent CKD, but their diagnostic utility remains challenging due to decreased renal clearance affecting plasma levels.
Why the study?
Do traditional circulating and imaging-based cardiac biomarkers predict cardiovascular events and death in non-dialysis-dependent patients with CKD?
Population
Non-dialysis-dependent patients with chronic kidney disease (predialysis CKD)
Design
Review
Authors
Discussion
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Member takes
Implication
Supports prognostic use in predialysis CKD but cautions on diagnostic cutoffs; leaves open prospective validation of adjusted thresholds.
Structured PICO
Do traditional circulating and imaging-based cardiac biomarkers predict cardiovascular events and death in non-dialysis-dependent patients with CKD?
P
Population
Non-dialysis-dependent patients with chronic kidney disease (predialysis CKD)
E
Exposure
Assessment of circulating (cTnT, BNP, NT-pro-BNP) and imaging-based (coronary artery calcium, left ventricular hypertrophy, carotid intima-media thickness) cardiac biomarkers
O
Outcome
Cardiovascular events and deathhard clinical
While cardiac biomarkers offer prognostic value in predialysis CKD, their diagnostic utility for acute events is limited by chronically elevated baseline levels, requiring adjusted cutoffs.
Limitations
- Decreased renal clearance may affect the plasma levels of these biomarkers
- Upper reference limits were originally derived in patients without CKD
- It is not known whether these biomarkers are modifiable and amenable to interventions that could change hard clinical outcomes
Cite This Study
Colbert et al. (2014) conducted a review in Non-dialysis-dependent chronic kidney disease (CKD). Cardiac biomarkers (cTnT, BNP, NT-pro-BNP, coronary artery calcium, left ventricular hypertrophy, carotid intima-media thickness) was evaluated on Cardiovascular events and death. Cardiac biomarkers may be used for prognostication in non-dialysis-dependent CKD, but their diagnostic utility remains challenging due to decreased renal clearance affecting plasma levels.