| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Received on June 8, 2005
Accepted on August 16, 2005
Proteomics and Protein Markers |
1 Department of Renal Medicine, East Kent Hospitals NHS Trust, Canterbury, Kent, United Kingdom
2 Clinical Biochemistry, East Kent Hospitals NHS Trust, Canterbury, Kent, United Kingdom
3 Bayer Diagnostics plc, Newbury, Berkshire, United Kingdom
* To whom correspondence should be addressed. E-mail: edmund.lamb{at}ekht.nhs.uk.
Background: Serum cardiac troponin concentrations are commonly increased in end-stage renal disease (ESRD) in the absence of an acute coronary syndrome (ACS). The data on cardiac troponin I (cTnI) are more variable than those for cardiac troponin T (cTnT). There is little information on cardiac troponin concentrations in patients with chronic kidney disease (CKD) who have not commenced dialysis.
Methods: We studied 222 patients: 56 had progressed to stage 3 (moderate CKD); 70 to stage 4 (severe CKD); and 96 to stage 5 (kidney failure). Patients underwent echocardiography and were followed prospectively for a median of 19 months; all causes of mortality was recorded.
Results: Overall, serum cTnT was increased above the 99th percentile reference limit in 43% of all CKD patients studied, compared with 18% for cTnI. Serum cTnT and cTnI concentrations were more commonly increased in the presence of more severe CKD (11 and 6 patients in stage 3, 27 and 8 in stage 4, and 57 and 24 in stage 5 (P <0.0001 and <0.02, respectively). Among 38 patients with detectable cTnI, 32 had detectable cTnT (rs = 0.67; P<0.0001). There was evidence that decreasing estimated glomerular filtration rate (eGFR) increased the odds of having detectable cTnT (P <0.001) but not cTnI (P = 0.128). There was no evidence to support an adjusted association of detectable cardiac troponins with increasing left ventricular mass index. Increased cTnT (P = 0.0097), but not cTnI, was associated with decreased survival.
Conclusions: Increased cTnT and cTnI concentrations are relatively common in predialysis CKD patients, in the absence of an ACS, including among those with stage 3 disease. The presence of left ventricular hypertrophy alone does not explain these data. Detectable cTnT was a marker of decreased survival.
The following articles in journals at HighWire Press have cited this article:
|
|
 |
|
  X. Ji, R. Takahashi, Y. Hiura, G. Hirokawa, Y. Fukushima, and N. Iwai Plasma miR-208 as a Biomarker of Myocardial Injury Clin. Chem., November 1, 2009; 55(11): 1944 - 1949. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A Roberts, D. L Hare, N. Macmillan, S. Ratnaike, K. Sikaris, and F. L Ierino Serial increased cardiac troponin T predicts mortality in asymptomatic patients treated with chronic haemodialysis Ann Clin Biochem, July 1, 2009; 46(4): 291 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Tsutamoto, C. Kawahara, M. Yamaji, K. Nishiyama, M. Fujii, T. Yamamoto, and M. Horie Relationship between renal function and serum cardiac troponin T in patients with chronic heart failure Eur J Heart Fail, July 1, 2009; 11(7): 653 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J M Wilson Diagnosis and treatment of acquired coronary artery disease in adults Postgrad. Med. J., July 1, 2009; 85(1005): 364 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Vickery, M. C. Webb, C. P. Price, R. I. John, N. A. Abbas, and E. J. Lamb Prognostic value of cardiac biomarkers for death in a non-dialysis chronic kidney disease population Nephrol. Dial. Transplant., November 1, 2008; 23(11): 3546 - 3553. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Y.-M. Wang and K.-N. Lai Use of Cardiac Biomarkers in End-Stage Renal Disease J. Am. Soc. Nephrol., September 1, 2008; 19(9): 1643 - 1652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schou, C. Torp-Pedersen, F. Gustafsson, J. Abdulla, and L. Kober Wall motion index, estimated glomerular filtration rate and mortality risk in patients with heart failure or myocardial infarction: A pooled analysis of 18,010 patients Eur J Heart Fail, July 1, 2008; 10(7): 682 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Unverir, B. C. Soner, E. Dedeoglu, O. Karcioglu, K. Boztok, and Y. Tuncok Renal and hepatic injury with elevated cardiac enzymes in Amanita phalloides poisoning: a case report Human and Experimental Toxicology, September 1, 2007; 26(9): 757 - 761. [Abstract] [PDF]
|
|
|
|
|
|
M. N. Fahie-Wilson, E. M. Hall, and E. J. Lamb The authors of the article cited above respond: Clin. Chem., December 1, 2006; 52(12): 2307 - 2309. [Full Text] [PDF]
|
|
|
|
|
|
M. N. Fahie-Wilson, D. J. Carmichael, M. P. Delaney, P. E. Stevens, E. M. Hall, and E. J. Lamb Cardiac Troponin T Circulates in the Free, Intact Form in Patients with Kidney Failure Clin. Chem., March 1, 2006; 52(3): 414 - 420. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
