Key result
Hemodialysis did not significantly alter pre- to post-session cTnI levels, though a minor decrease occurred between the first and second weekly pre-dialysis sessions (0.018 to 0.016 ng/mL; p=0.002).
Why the study?
Does hemodialysis affect cardiac troponin I levels in asymptomatic ESRD patients?
Observational (n=30)
Does hemodialysis affect cardiac troponin I levels in asymptomatic ESRD patients?
Hemodialysis does not significantly alter cardiac troponin I levels in asymptomatic ESRD patients, preserving the biomarker's diagnostic accuracy in this population.
Troponin I stability across sessions supports diagnostic use in asymptomatic ESRD; leaves open validation in acute or symptomatic cohorts.
BACKGROUND: End-stage renal disease (ESRD) represents a situation in which persistently elevated levels of cardiac troponins I (cTnI) are frequently found in the absence of clinically evident cardiac disease. Moreover, the effect of hemodialysis (HD) on cTnI levels is not definitively elucidated. The aim of this study was to investigate the effects of HD on cTnI levels in ESRD patients. METHODS: We enrolled 30 asymptomatic ESRD patients on maintenance HD. All the patients were dialyzed thrice weekly. We compared each other's cTnI levels obtained before HD sessions (pre-HD) and cTnI levels obtained before and after HD sessions (post-HD). RESULTS: The median value of baseline cTnI, measured before the first dialysis session of the week, was 0.018 ng/mL (interquartile range 0.012-0.051) and elevated levels (>0.034 ng/mL) were found in 9 (30%) patients. Pre-HD cTnI levels showed a statistically significant decrease between the first and the second weekly HD sessions (from 0.018 to 0.016 ng/mL; p = 0.002), while no difference was observed between the second and the third sessions over the week. Finally, no statistically significant differences were found between pre-HD and post-HD cTnI levels, considering each HD session and the averaged cTnI values. CONCLUSIONS: Our results indicate that HD does not significantly affect cTnI levels. Even when statistically significant, the observed changes were without clinical relevance indicating that HD does not affect by itself the diagnostic accuracy of cTnI assay in ESRD patients.
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Castini et al. (2017) conducted an observational in End-stage renal disease (n=30). Hemodialysis vs. Pre-hemodialysis baseline was evaluated on Cardiac troponin I (cTnI) levels before and after hemodialysis sessions. Hemodialysis did not significantly alter pre- to post-session cTnI levels, though a minor decrease occurred between the first and second weekly pre-dialysis sessions (0.018 to 0.016 ng/mL; p=0.002).
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