Hemodialysis acutely increased cTnT (P<0.01) and decreased cTnI (P<0.001), and sporadic or persistently increased troponin levels predicted cardiac complications (8.5% mortality at 2 years).
Cohort (n=59)
Do cardiac troponin T and I levels predict cardiac complications in patients with end-stage renal failure on hemodialysis?
Dialysis acutely alters troponin levels, and persistently elevated cTnT and cTnI predict cardiac complications in patients with end-stage renal failure, suggesting blood should be drawn before dialysis.
p-value: p=<0.01
BACKGROUND: In patients suffering from end-stage renal failure, cardiac troponin T (cTnT) and I (cTnI) may be increased in serum without other signs of acute myocardial damage. Whether these increases are specific to myocardial injury or nonspecific is not completely clear. METHODS: We investigated time courses of cTnT and cTnI over 1 year and the clinical outcome over 2 years in 59 patients with end-stage renal failure undergoing chronic hemodialysis. At the start of the study, we divided the patients into two groups, group 1, without history of cardiac failure, and group 2, with history of cardiac failure, and looked for differences between the groups in later adverse outcome. cTnT was measured using the Enzymun((R)) troponin T assay on an ES 700 analyzer (Roche). cTnI was measured on a Stratus((R)) II analyzer (Dade Behring). Creatinine and blood urea nitrogen were measured on a Vitros((R)) 950 IRC (Ortho). RESULTS: Dialysis acutely increased cTnT (P: <0.01) and decreased cTnI (P: <0.001) regardless of the dialysis membrane used. Although statistically not significant, cTnT but not cTnI was increased more frequently in group 2 than in group 1, in some cases over the whole study period. Five patients (8.5%) died of cardiac complications within 2 years; all of them had mostly increased cTnT and, in one or more samples, increased cTnI. CONCLUSIONS: Dialysis alters measured cTnT and cTnI concentrations in serum. In patients suffering from end-stage renal failure, sporadic or persistently increased cTnT and cTnI appear to predict cardiac complications. Because of the effects of the dialysis procedure on troponin values, we recommend that blood be collected before dialysis.
Wayand et al. (Fri,) conducted a cohort in End-stage renal failure (n=59). Hemodialysis vs. Patients without history of cardiac failure vs patients with history of cardiac failure was evaluated on Changes in cTnT and cTnI during dialysis and cardiac complications over 2 years (p=<0.01). Hemodialysis acutely increased cTnT (P<0.01) and decreased cTnI (P<0.001), and sporadic or persistently increased troponin levels predicted cardiac complications (8.5% mortality at 2 years).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: