Troponins in acute kidney injury

David Song1, Janak R de Zoysa, Alvin Ng

  • 1Department of Chemical Pathology, Labplus, Auckland City Hospital, Auckland, New Zealand. dsong@adhb.govt.nz

Renal Failure
|October 21, 2011
PubMed

Insights

Acute kidney injury (AKI) can elevate cardiac troponin levels, even without other heart conditions. This study shows impaired kidney function directly impacts troponin measurements in AKI patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Cardiac troponins are key biomarkers for myocardial injury.
  • Acute kidney injury (AKI) is common and can affect cardiac biomarker levels.
  • Previous studies suggest a link between kidney function and troponin levels, but often in chronic settings.

Purpose of the Study:

  • To investigate and describe cardiac troponin levels in patients presenting with acute kidney injury (AKI).
  • To determine if AKI, independent of other confounders, influences troponin measurements.
  • To compare troponin I, troponin T, and creatine kinase-MB (CKMB) in AKI patients.

Main Methods:

  • Prospective observational study in a tertiary hospital setting.
  • Measurement of troponin I, troponin T, and CKMB in subjects with AKI.
  • Exclusion of patients with known causes of elevated troponin levels to isolate the effect of AKI.

Main Results:

  • Six out of nineteen AKI subjects exhibited elevated troponin I and T levels (above 99th percentile).
  • High concordance was observed between troponin I and troponin T results.
  • Concordance between elevated troponin and CKMB was lower (45%).
  • Factors associated with elevated troponin included age >60, abnormal ECG, and prior ischemic heart disease.

Conclusions:

  • This study provides evidence that acute kidney injury, without confounding factors, can lead to elevated cardiac troponin levels.
  • Impaired renal function appears to influence plasma troponin levels in AKI.
  • Findings suggest a similar impact of renal function on troponin levels in both acute and chronic kidney disease.
Abstract

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