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Circulating cardiac troponin-T in patients before and after renal transplantation
S Fredericks1, R Chang, H Gregson
1Analytical Unit, Cardiological Sciences, St. George's Hospital Medical School, London SW17 0RE, UK. frederic@sghms.ac.uk
Insights
Cardiac troponin T (cTnT) levels in renal failure patients did not significantly change after kidney transplant. However, elevated cTnT was linked to underlying cardiac issues or risk factors in these patients.
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- The utility of cardiac troponin T (cTnT) in renal failure patients is debated.
- Elevated cTnT levels can occur without apparent cardiac damage in this population.
- This study investigates cTnT changes following renal transplantation.
Purpose of the Study:
- To assess the relationship between circulating cardiac troponin T concentrations and improved renal function.
- To evaluate cTnT levels in end-stage renal disease patients before and after kidney transplantation over one year.
Main Methods:
- Plasma cTnT was measured in 32 end-stage renal disease patients pre-transplant and at 1, 3, 6, and 12 months post-transplant.
- Patient characteristics including diabetes, hyperlipidemia, and smoking status were recorded.
Main Results:
- At transplantation, 9.4% of patients had elevated cTnT (>0.1 microg/l).
- An additional five patients showed raised cTnT levels during the one-year follow-up.
- No clear trend in cTnT concentrations correlated with improved renal function.
Conclusions:
- Improved renal function post-transplant did not significantly alter overall circulating cTnT concentrations.
- All patients with elevated cTnT had identifiable underlying pathologies or multiple cardiac risk factors.
- Cardiac troponin T elevations in renal failure patients warrant further investigation into associated cardiac conditions and risk factors.
Background:
The diagnostic and prognostic use of cardiac troponin T (cTnT) in patients with renal failure has been questioned. Raised serum concentrations of cTnT, with no apparent signs of cardiac damage using conventional methods of detection, have been reported. We aimed to relate circulating concentrations of cTnT to improved renal function following renal transplantation over a one-year period.
Method:
Plasma cTnT was analysed from patients with end stage renal disease before and after transplantation and subsequently at 1, 3, 6 and 12 months. Eight patients had diabetes, 14 had hyperlipidaemia, 8 were smokers and 4 were ex-smokers; all were hypersensitive.
Results:
At the time of transplantation, 3 of the 32 patients (9.4%) had plasma cTnT concentrations above 0.1 microg/l. In addition to these three patients, five others showed raised cTnT over the one-year period.
Conclusions:
The overall trend in circulating cTnT concentrations did not seem to be affected by improved renal function. However, all of the patients that had raised cTnT concentrations at any stage of the one-year period had explainable pathologies or were exposed to multiple cardiac risk factors.
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