Levels of creatine kinase MB-mass in chronic kidney disease patients on maintenance hemodialysis without coronary complications

Abstract

Introduction: A triad of clinical evaluation, electrocardiography and biomarkers of acute cardio necrosis are basis for diagnosing acute coronary syndrome (ACS). Evaluation of ACS by electrocardiography can be inconclusive in patients on maintenance hemodialysis; thereby making cardiac biomarkers better indicators. Hemodialysis is known to alter troponin I values with studies suggesting high false positives but not for the values of CKMB mass. Aim: The aim of the study was to estimate the levels of cardiac CKMB-mass in patients with stage IV/stage V renal failure on maintenance hemodialysis (MHD) with no evidence of cardiac disease, and to correlate these values with manufactures guidelines for healthy individuals (cut off of Materials and Methods: The study was conducted on 23 patients between age group 20 to 70 years, diagnosed with stage IV or V Chronic Kidney disease (CKD) (confirmed biochemically and ultrasonographically). These patients were undergoing regular biweekly regime of maintenance hemodialysis for more than 3 months at dialysis unit PESIMSR, Kuppam. CKMB mass levels were measured in these patients. Results and Conclusion: The kidney function tests and electrolyte values were deranged in patients with CKD, however as the patients were on calcium supplementation, mineral levels were within normal range. Liver function tests of these patients were found to be normal. The hemoglobin and RBC levels were lower due to CKD associated anemia. CKMB-mass levels of these patients were done in Biomerieux Vidas analyzer using Enzyme linked fluorescent assay (ELFA) method. The values were within manufacturer’s cutoff range of 5ng/ml with mean value of 3.0±1.69 ng/ml. The patients were followed up either until death or for 24 months for any cardiac related events and follow up rate was 99%. The overall survival rates of the patients were found to be 77% and none of the patients were found to have developed cardiac related events and specifically myocardia