Influence of sampling time and ultrafiltration coefficient of the dialysis membrane on cardiac troponin I and T.

Abstract

Abstract Context.—The measurement of cardiac troponin I (TnI) and T (TnT) is essential to diagnose, guide therapy, and predict outcomes of the acute coronary syndrome. Increased levels of troponins, especially TnT, are frequently observed in patients on chronic hemodialysis (HD), reflecting ongoing and subclinical myocardial damage. Objective.—Because these markers are increasingly used for stratification of cardiac risk in these patients, their behavior during HD should be acknowledged to optimize their clinical usefulness. Design.—TnI and TnT were measured in 34 patients pre-HD and post-HD by either high- or low-flux membranes. The post-HD concentrations were corrected for hemoconcentration. Results.—Pre-HD levels above the 99th percentile reference limits of the general population of TnI (>0.06 ng/ mL) and TnT (>0.01 ng/mL) were observed in 9% (13% high-flux, 6% low-flux membranes) and 88% (94% high-flux; 83% low-flux membranes) of the patients, respectively. No significant difference was observed in m...