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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Predictive markers of asymptomatic atherosclerosis in end-stage renal disease patients

Rüya Mutluay1, Ceyla Konca, Yasemin Erten

  • 1Department of Nephrology, Gazi University Hospital, 06100, Ankara, Turkey.

Renal Failure
|May 8, 2010
PubMed

Insights

In end-stage renal disease (ESRD) patients, elevated cardiac injury markers like myoglobin and creatine kinase-MB (CK-MB) correlate with atherosclerosis. Cardiac troponin I (cTnI) may be a more reliable marker for cardiovascular events in ESRD.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • End-stage renal disease (ESRD) is linked to accelerated atherosclerosis and increased cardiovascular mortality.
  • Standard cardiac injury markers (myoglobin, CK-MB, troponins) can be falsely elevated in ESRD patients, complicating diagnosis.
  • Accurate assessment of cardiovascular risk in ESRD is crucial.

Purpose of the Study:

  • To compare serum levels of myoglobin, CK-MB, and troponin I (cTnI) in ESRD patients without coronary artery disease (CAD) against healthy controls.
  • To investigate the association between these cardiac markers and carotid artery intima-media thickness (CA-IMT), high-sensitive C-reactive protein (hs-CRP), and serum uric acid (SUA) in ESRD patients.

Main Methods:

  • Study included 52 ESRD patients (hemodialysis and peritoneal dialysis) and 17 healthy controls.
  • Serum levels of myoglobin, CK-MB, and cTnI were measured in all participants.
  • Ultrasonographic CA-IMT was determined; SUA and hs-CRP were measured in ESRD patients.

Main Results:

  • ESRD patients showed significantly higher serum myoglobin, CK-MB levels, and mean CA-IMT compared to controls (p < 0.01).
  • Serum cTnI levels did not differ significantly between ESRD patients and controls (p = 0.70).
  • Positive correlations were found between CA-IMT and cTnI (p = 0.003), hs-CRP (p = 0.03), and SUA (p = 0.003).

Conclusions:

  • Cardiac troponin I (cTnI) may be a more sensitive marker for cardiovascular events in patients with renal failure.
  • Beyond traditional risk factors, cTnI, hs-CRP, and SUA may predict premature atherosclerosis in ESRD patients.
Abstract

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