Abstract
We aimed to study level of cardiac troponin T(cTnT) and its possible influence factorsin maintenance hemodialysis (MHD) patients. Blood was obtained from 123 MHD patients before undergoing hemodialysis. Patients with cardiovascular disease (CVD) had higher cTnT levels than those without CVD (0.062 [0.044 - 0.083] ng/mL vs 0.031[0.020 - 0.046] ng/mL, P = 0.002). Patients with diabetes mellitus (DM) had higher cTnT levels than those non-DM (0.061[0.042 - 0.102] ng/mL vs 0.044[0.025 - 0.064] ng/mL, P = 0.003). We found that in all MHD patients, cTnT correlated positively with age(ρ = 0.309, P = 0.001), glycated albumin (ρ = 0.192, P = 0.040), amino-terminal pro-B-natriuretic peptide (NT-proBNP) (ρ = 0.448, P < 0.001), high-sensitive C reactive protein(hsCRP) (ρ = 0.335, P < 0.001), carotid artery intima-media thickness (ρ = 0.315, P = 0.004) and left ventricular mass index(ρ = 0.369, P < 0.001); negatively with pre-albumin(ρ = -0.280, P = 0.002), high density lipoprotein cholesterol(ρ = -0.201, P = 0.047). Age (β = 0.204, P = 0.043), NT-proBNP (β = 0.299, P = 0.010) and left ventricular mass index (β = 0.345, P = 0.003) were independently associated cTnT. Receiver operating characteristic (ROC) curves analysis showed the correlation between cTnT and CVD was more closely than NT-proBNP and hsCRP, the correlation between cTnT and left ventricular hypertrophy was lower than NT-proBNP, and higher than hsCRP. In conclusions, serum cTnT is markedly elevated in MHD patients; Serum cTnT is associated with advanced age, fluid overload, malnutrition, microinflammation, left ventricular hypertrophy and CVD in MHD patients.
Highlights
Chronic kidney disease (CKD), increasing mortality as well as health care expenditure, affects 5-10% of the world’s population, and renal replacement therapies, including maintenance hemodialysis (MHD) and peritoneal dialysis, are regarded as effective methods for patients with end-stage CKD (Plata et al, 1998; Eknoyan et al, 2004; Waziri et al, 2019)
4 Discussion In MHD patients, the factors related to the increase of cTnT are reported abroad, including cardiac hypertrophy, cardiac insufficiency, volume load, myocardial stunning, diabetes mellitus, history of cardiovascular disease, age, chronic inflammation, malnutrition, oxidative stress, increase of dialysis time and others, and the increase of its level is significantly correlated with the increase of mortality (Sommerer et al, 2007; Jacobs et al, 2009; Kalaji & Albitar, 2012; Breidthardt et al, 2012)
Our results showed that 73.2% of MHD patients had increased cTnT, which confirmed that there was a considerable increase in serum cTnT level of MHD patients without acute coronary syndrome at different levels
Summary
Chronic kidney disease (CKD), increasing mortality as well as health care expenditure, affects 5-10% of the world’s population, and renal replacement therapies, including maintenance hemodialysis (MHD) and peritoneal dialysis, are regarded as effective methods for patients with end-stage CKD (Plata et al, 1998; Eknoyan et al, 2004; Waziri et al, 2019). While prolonging survival, reducing morbidities, and improving patients’ quality of life, renal replacement therapies increase the chance of occurrence of cardiovascular disease (CVD) (cardiovascular disease), which accounts for almost 40-50% of all-cause mortality, a rate 10 to 30 fold higher than in the general population (Schocken et al, 2008; Moor et al, 2017). Serum cTnT levels of MHD patients were detected to explore their pathophysiological mechanism and clinical significance
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