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Troponin T hemodialysis

Lijie Ma, Sumei Zhao
BACKGROUND: No consensus exists regarding the factors influencing mortality in patients undergoing hemodialysis (HD). This meta-analysis aimed to evaluate the impact of various patient characteristics on the risk of mortality in such patients. METHODS: PubMed, Embase, and Cochrane Central were searched for studies evaluating the risk factors for mortality in patients undergoing HD. The factors included age, gender, diabetes mellitus (DM), body mass index (BMI), previous cardiovascular disease (CVD), HD duration, hemoglobin, albumin, white blood cell, C-reactive protein (CRP), parathyroid hormone, total iron binding capacity (TIBC), iron, ln ferritin, adiponectin, apolipoprotein A1 (ApoA1), ApoA2, ApoA3, high-density lipoprotein (HDL), total cholesterol, hemoglobin A1c (HbA1c), serum phosphate, troponin T (TnT), and B-type natriuretic peptide (BNP)...
February 22, 2017: International Journal of Cardiology
Bryan A Ross, Ron Wald, Marc B Goldstein, Darren A Yuen, Jonathon Leipsic, Mercedeh Kiaii, Andrea Rathe, Djeven P Deva, Anish Kirpalani, Olugbenga O Bello, John J Graham, Howard Leong-Poi, Kim A Connelly, Andrew T Yan
BACKGROUND: We sought to assess the relationships between left ventricular (LV) remodelling and the mechanical and uremic stressors in hemodialysis patients. METHODS: In this prospective 2-centre cohort study, 67 prevalent hemodialysis patients were followed for 1 year. Data on routine bloodwork and predialysis blood pressure (BP) measurements were collected over a 12-week period. LV end-diastolic volume (LVEDV) and LV mass (LVM) were measured using cardiac magnetic resonance imaging and indexed...
April 2017: Canadian Journal of Cardiology
Matthew B Rivara, Catherine K Yeung, Cassianne Robinson-Cohen, Brian R Phillips, John Ruzinski, Denise Rock, Lori Linke, Danny D Shen, T Alp Ikizler, Jonathan Himmelfarb
BACKGROUND: Oxidative stress is highly prevalent in patients with end-stage renal disease and is linked to excess cardiovascular risk. Identifying therapies that reduce oxidative stress has the potential to improve cardiovascular outcomes in patients undergoing maintenance dialysis. STUDY DESIGN: Placebo-controlled, 3-arm, double-blind, randomized, clinical trial. SETTING & PARTICIPANTS: 65 patients undergoing thrice-weekly maintenance hemodialysis...
March 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Zhen Zhang, Bo Shen, Xuesen Cao, Zhonghua Liu, Xiaohong Chen, Yuxin Nie, Jinbo Yu, Jianzhou Zou, Xiaoqiang Ding
BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) is a novel cardiovascular biomarker. This study aimed to evaluate the prognostic value of sST2 in hemodialysis patients. METHODS: Four hundred and fourteen maintenance hemodialysis (MHD) patients were enrolled and followed up prospectively. Serum sST2 levels were measured. The endpoint was all-cause and cardiovascular mortality. RESULTS: During a median follow-up of 22.3 months, 58 patients died, including 31 cardiovascular deaths...
2017: Blood Purification
Zhen Wang, Chao Yu, Xin-Hua Li, Bing-Qing Deng
BACKGROUND: There is limited information about oxidative stress and inflammation on the mortality of Chinese hemodialysis (HD) patients. SUBJECTS AND METHODS: A total of 177 HD patients and 35 healthy controls were enrolled. Their demographic information, clinical characteristics, oxidant and inflammation markers were compared. Multivariate Cox regression analysis was used to assess the risk factors for mortality. RESULTS: Twenty-seven (15...
November 2017: Renal Failure
Juan S Moreno, Augusto J Lépori, Pablo Novoa, Rafael De Elia, Ricardo Guglielmone, Julio P Bono
INTRODUCTION: The end stage renal disease confers a high morbidity and mortality risk, mainly due to cardiovascular disease. The cardiac T troponin and carbohydrate antigen-125 (CA-125) are useful biomarkers to determine cardiovascular prognosis in order to start preventive treatment in the high risk patients. METHODS: We included patients with end stage renal disease in hemodialysis treatment. Plasma high sensitivity cardiac T troponin (hs-TNT) and CA-125 were measured at the beginning of follow up...
2016: Revista de la Facultad de Ciencias Médicas
Reneta Yovcheva Koycheva, Vasil Cholakov, Jivko Andreev, Margarit Penev, Rosen Iliev, Krasimira Nancheva, Vanya Tsoneva
BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Miranda van Berkel, Marijke J E Dekker, Hanneke Bogers, Daniel A Geerse, Constantijn J A M Konings, Volkher Scharnhorst
Acute myocardial infarction (AMI) is defined as a dynamic change in cardiac troponin (cTn) with at least one cTn value exceeding the 99 th percentile of a reference population in combination with typical clinical symptoms. In hemodialysis (HD) patients, a broad range of cTn concentrations is found, partially due to patient-specific comorbidities. Therefore, the 99 th percentile cannot be used in HD patients and decision algorithms to diagnose AMI should be based on temporal variations of troponin. In this study, relative and absolute variations of cTn in a large population of asymptomatic hemodialysis patients were established during a period of 15 months...
May 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Yader Sandoval, Charles A Herzog, Sara A Love, Jing Cao, Yan Hu, Alan H B Wu, David Gilbertson, Steven M Brunelli, Amy Young, Ranka Ler, Fred S Apple
INTRODUCTION: Serial changes in cardiac troponin in hemodialysis (HD) patients have uncertain clinical implications. We evaluated associations of adverse outcomes in HD patients with reference change value (RCV) data and tertile concentrations for cardiac troponin I (cTnI) and cTnT measured by high-sensitivity (hs) assays. METHODS: RCV data and tertiles for hs-cTnI and hs-cTnT were determined from plasma samples collected 3 months apart in 677 stable outpatient HD patients and assessed for their associations with adverse outcomes using adjusted Cox models...
April 2016: Clinical Chemistry
Hua-Lan Huang, Shuai Zhu, Wei-Qing Wang, Xin Nie, Ying-Ying Shi, Yong He, Hao-Lan Song, Qiang Miao, Ping Fu, Lan-Lan Wang, Gui-Xing Li
CONTEXT: Cardiac troponins have become the gold standard for diagnosing acute myocardial infarction (AMI) in the general population; however, their diagnostic accuracy for hemodialysis (HD) patients presenting with chest pain or dyspnea is uncertain. OBJECTIVE: To examine the diagnostic accuracy of high-sensitivity cardiac troponin T (hs-cTnT) assay for AMI in HD patients. DESIGN: In this prospective study, we enrolled 670 consecutive stable HD patients presenting with chest pain or dyspnea on routine predialysis therapy in the nephrology department...
January 2016: Archives of Pathology & Laboratory Medicine
Alicja E Grzegorzewska, Krzysztof Cieszyński, Leszek Niepolski, Andrzej Kaczmarek, Anna Sowińska
PURPOSE: We examined the association between extracorporeal dialysis (ED)-related effective blood flow (eQB) and serum cardiac troponin T (cTnT) as a possible indicator of silent myocardial damage in stable ED patients. METHODS: In a cross-sectional study, cTnT was determined in 247 ED patients dialyzed using stable eQB and dialysate flow (QD). In a prospective study, 91 patients were switched from low-flux (LF) to high-flux (HF) hemodialysis (HD), and subsequently, the eQB increased, and the QD decreased; 65 patients continued LF-HD with stable eQB and QD...
March 2016: International Urology and Nephrology
Anne-Sophie Bargnoux, Nils Kuster, Laure Patrier, Anne-Marie Dupuy, Gaelle Tachon, Francois Maurice, Bouchra Badaoui, Lotfi Chalabi, Stéphanie Badiou, Sebastien Deleuze, Hélène Leray-Moragues, Marion Morena, Bernard Canaud, Jean-Paul Cristol
BACKGROUND: New highly sensitive (hs) assays have challenged the interpretation of cardiac troponins (cTn). The present study was designed to evaluate simultaneously conventional cTnT and cTnI together with their corresponding highly sensitive determinations in stable hemodialysis (HD) patients. Ability of cTn to stratify HD patient risk was assessed. METHODS: A total of 224 stable HD patients was included in this observational study. cTnT and hs-cTnT were measured using Roche cTnT/hs-cTnT assays based on a Cobas e601® analyzer...
April 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Maurits S Buiten, Mihály K de Bie, Joris I Rotmans, Friedo W Dekker, Marjolijn van Buren, Ton J Rabelink, Christa M Cobbaert, Martin J Schalij, Arnoud van der Laarse, J Wouter Jukema
BACKGROUND: Serum troponin assays, widely used to detect acute cardiac ischemia, might be useful biomarkers to detect chronic cardiovascular disease (CVD). Cardiac-specific troponin-I (cTnI) and troponin-T (cTnT) generally detect myocardial necrosis equally well. In dialysis patients however, serum cTnT levels are often elevated, unlike cTnI levels. The present study aims to elucidate the associations of cTnI and cTnT with CVD in clinically stable dialysis patients. METHODS: Troponin levels were measured using 5th generation hs-cTnT assays (Roche) and STAT hs-cTnI assays (Abbott) in a cohort of dialysis patients...
2015: PloS One
Krzysztof Hoppe, Krzysztof Schwermer, Patrycja Klysz, Dorota Radziszewska, Peter Sawatiuk, Ewa Baum, Jolanta Kaczmarek, Magdalena Roszak, Malgorzata Kaluzna, Bengt Lindholm, Krzysztof Pawlaczyk, Andrzej Oko
This study aimed to assess cardiac troponin T (cTnT) and hydration state as cardiovascular (CV) risk markers in hemodialysis (HD) patients. Two hundred and forty one patients were divided according to HD vintage into two groups: SV (HD ≤24 months) and LV. Water balance was assessed with overhydration (OH%; bioimpedance analysis) and daily diuresis (DD); CV dysfunction with cTnT and heart ultrasound; nutrition with subjective global assessment (SGA), cholesterol (TC) and albumin. SV had lower OH% (2.8 vs. 3...
2015: Blood Purification
Krzysztof Schwermer, Krzysztof Hoppe, Dorota Radziszewska, Patrycja Kłysz, Peter Sawatiuk, Justin Nealis, Małgorzata Kałużna, Jolanta Kaczmarek, Ewa Baum, Bengt Lindholm, Krzysztof Pawlaczyk, Andrzej Oko
INTRODUCTION: N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) is an established biomarker of heart failure in the general population. However, its diagnostic value is unclear in hemodialysis (HD) patients owing to renal insufficiency. OBJECTIVES: The aim of the study was to establish the usefulness of NT‑proBNP for hydration assessment and the relation of NT‑proBNP to the nutritional state and prognosis of survival. PATIENTS AND METHODS: In 321 HD patients (206 men; mean age, 65...
2015: Polskie Archiwum Medycyny Wewnętrznej
Junnichi Ishii, Hiroshi Takahashi, Fumihiko Kitagawa, Atsuhiro Kuno, Ryuunosuke Okuyama, Hideki Kawai, Takashi Muramatsu, Hiroyuki Naruse, Sadako Motoyama, Shigeru Matsui, Midori Hasegawa, Toru Aoyama, Daisuke Kamoi, Hirotake Kasuga, Hideo Izawa, Yukio Ozaki, Yukio Yuzawa
BACKGROUND: We prospectively investigated the prognostic value of the combined use of cardiac troponin T (TnT), B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (CRP) for long-term mortality in hemodialysis (HD) patients. METHODS AND RESULTS: Baseline measurements of TnT, BNP, and CRP were performed in 516 patients on chronic HD. Patients were followed up for 10 years. Using the Cox multivariate model with these 3 biomarkers as variables categorized into tertiles for mortality, a simplified score was obtained by underscoring individual biomarkers based on the adjusted hazard ratio (HR)...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Emilie Laveborn, Krister Lindmark, Malin Skagerlind, Bernd Stegmayr
BACKGROUND: Brain natriuretic peptide (BNP), N-terminal-proBNP (NT-proBNP), and high sensitive cardiac troponin T (TnT) are markers that are elevated in chronic kidney disease and correlate with increased risk of mortality. Data are conflicting on the effect of biomarker levels by hemodialysis (HD).Our aim was to clarify to what extent HD with low-flux (LF) versus high-flux (HF) membranes affects the plasma levels of BNP, NT-proBNP, and TnT. METHODS AND MATERIALS: 31 HD patients were included in a crossover design, randomized to start dialysis with a LF-HD or HF-HD dialyzer...
February 2015: International Journal of Artificial Organs
Andrzej Jaroszyński, Anna Jaroszyńska, Janusz Siebert, Wojciech Dąbrowski, Jarosław Niedziałek, Anna Bednarek-Skublewska, Tomasz Zapolski, Andrzej Wysokiński, Wojciech Załuska, Andrzej Książek, Todd T Schlegel
BACKGROUND: Given that cardiac disease is the leading cause of mortality in hemodialysis (HD) patients, identification of patients at risk for cardiac mortality is crucial. The aim of this study was to determine if positive T-wave amplitude in lead aVR (TaVR) was predictive of cardiovascular (CV) mortality and sudden cardiac death (SCD) in a group of HD patients. METHODS AND RESULTS: After exclusion, 223 HD patients were prospectively followed-up for 25.43 ± 3...
December 2015: Clinical and Experimental Nephrology
Christiane Drechsler, Sahir Kalim, Julia B Wenger, Pirianthini Suntharalingam, Tammy Hod, Ravi I Thadhani, S Ananth Karumanchi, Christoph Wanner, Anders H Berg
Serum carbamylated albumin (C-Alb) levels are associated with excess mortality in patients with diabetic end-stage renal disease. To gain insight into the pathophysiology of carbamylation, we determined associations between C-Alb and causes of death in patients on chronic hemodialysis. The Die Deutsche Diabetes Dialyse Studie (4D study) was a randomized controlled trial testing the effects of atorvastatin on survival in diabetic patients on dialysis during a median follow-up of 4 years. We stratified 1161 patients by C-Alb to see whether differences in carbamylation altered the effects of atorvastatin on survival...
June 2015: Kidney International
Ferruh Artunc, Albina Nowak, Christian Müller, Andreas Peter, Nils Heyne, Hans-Ulrich Häring, Björn Friedrich
BACKGROUND/AIMS: Determination of peptide biomarkers such as troponins, natriuretic peptides or the recently reported FGF23 can be useful to identify hemodialysis patients with a high risk of mortality. However, it is desirable to focus on few robust parameters to warrant their routine application. METHODS: In a prospective cohort study with 239 prevalent hemodialysis patients we studied the prognostic significance of 10 simultaneously determined modern peptide biomarkers (high sensitive troponin I and T, NT-pro-BNP, BNP, MR-pro-ANP, MR-pro-ADM, CT-pro-ET1, copeptin, FGF23 and a-Klotho) and compared them with parameters traditionally associated with mortality (PTH, Ca, Pi, albumin, CRP, cholesterol, AP)...
2014: Kidney & Blood Pressure Research
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