Cardiac troponin T and end stage renal disease

OBJECTIVE: The aim of this study is to investigate the relationship between serum concentration of cardiac troponin T (cTnT) and other cardiac markers and ischemic heart disease (IHD) in end stage renal disease (ESRD) patients on chronic hemodialysis (HD).

METHODS: This study was carried out at King Fahd Specialist Hospital, Buraidah, Kingdom of Saudi Arabia from July 2002 to September 2003. Cardiac troponin T was measured using Elecsys 2020 immunoassay system, a method that is specific for cTnT. The analytical range of cTnT assay was 0.01-25.0 ug/L. Seventy-three patients were divided into 4 groups: 20 patients with history of IHD, 17 patients with diabetes, 19 patients with diabetes and IHD and 17 patients without evidence of myocardial damage.

RESULTS: Cardiac troponin T concentrations were >/=0.1 ug/L in 58% of HD patients. Fifty-three percent of diabetic patients had an increased cTnT, 37% of IHD patients had an increased cTnT, 59% of IHD and diabetic patients had an increased cTnT and 29% of noncardiac disease patients had an increased cTnT. Cardiac troponin T was increased more frequently in post-hemodialysis samples (13% pre-hemodialysis and 21% post-hemodialysis).

CONCLUSION: Dialysis may alter measured cTnT concentrations in ESRD patients undergoing chronic dialysis. Sporadic or persistently increased cTnT appear to be the most specific of the currently available biochemical markers to predict subclinical myocardial damage in ESRD patients.