Related Experiment Video
Updated: Apr 21, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Early markers of cardiovascular risk in chronic kidney disease
Silvia Lai1, Mira Dimko, Alessandro Galani
1Department of Clinical Medicine, Sapienza University of Rome , Rome , Italy .
Insights
In chronic kidney disease (CKD) patients, elevated cardiac biomarkers like NT-proBNP and cTnT, along with risk factors such as uric acid and homocysteine, correlate with atherosclerosis. These markers aid in assessing cardiovascular risk in early CKD stages.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Chronic kidney disease (CKD) significantly increases cardiovascular (CV) morbidity and mortality.
- CKD patients exhibit accelerated atherosclerosis, inflammation, and endothelial dysfunction.
- Nontraditional CV risk factors and cardiac biomarkers are implicated in CKD's increased CV burden.
Purpose of the Study:
- Investigate relationships between serum cardiac biomarkers, nontraditional CV risk factors, inflammatory markers, and atherosclerosis predictors in CKD patients.
- Evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), serum uric acid, homocysteine, CRP, ferritin, fibrinogen, cIMT, baFMD, and LVMI.
- Assess these markers in early-stage (2/3 KDOQI) CKD.
Main Methods:
- Study included 50 patients with stage 2/3 CKD and 18 healthy controls.
- Measured cardiac markers (cTnT, NT-proBNP), renal function, inflammatory markers (CRP, ferritin, fibrinogen), serum uric acid, and homocysteine.
- Assessed left ventricular mass index (LVMI), carotid intima-media thickness (cIMT), and brachial artery flow-mediated dilation (baFMD).
Main Results:
- CKD patients showed elevated NT-proBNP and cTnT, serum uric acid, and homocysteine compared to controls.
- Increased levels of these markers positively correlated with higher cIMT and LVMI.
- Reduced baFMD was observed in CKD patients.
Conclusions:
- Serum cardiac biomarkers and nontraditional CV risk factors are elevated in early CKD (stage 2/3 KDOQI).
- These markers help explain the high CV morbidity and mortality in CKD.
- NT-proBNP and cTnT are useful clinical biomarkers for assessing atherosclerosis predictors in CKD.
Background:
Patients with chronic kidney disease (CKD) present a markedly increased cardiovascular (CV) morbidity and mortality since the early stages and have a high prevalence of accelerated atherosclerosis, inflammation and endothelial dysfunction. Nontraditional cardiovascular risk factors and serum cardiac biomarkers would contribute to explain this increased morbidity.
Aim:
The aim is to investigate the relation among serum cardiac biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), nontraditional cardiovascular risk factors (serum uric acid, homocysteine), inflammatory indexes (C-reactive protein (CRP) serum ferritin, fibrinogen) and noninvasive predictors of atherosclerosis (carotid intima-media thickness (cIMT), brachial artery flow mediated dilation (baFMD), and left ventricular mass index (LVMI)) in CKD patients.
Materials And Methods:
In 50 patients with CKD in stage 2/3 kidney disease outcomes quality initiative (KDOQI) and 18 age- and sex-matched healthy controls, the following parameters were measured: cardiac markers (cTnT and NT-proBNP), renal function, inflammatory markers (CRP, serum ferritin and fibrinogen), serum uric acid and homocysteine. We have also evaluated LVMIs, cIMT and baFMD.
Results:
In our study, we showed an increase of NT-proBNP and the serum cTnT, of serum uric acid and homocysteine with a positive correlation with the increase of cIMT and LVMI and reduced baFMD compared with the controls.
Conclusions:
Serum cardiac biomarkers and nontraditional cardiovascular risk factors increase already in the stage 2/3 KDOQI contributing to explain the high cardiovascular morbidity and mortality of these patients. The NT-proBNP seems to have a rise earlier compared with serum cTnT; however, both seemed to be a useful clinical biomarker for evaluating noninvasive predictors of atherosclerosis in CKD patients.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Chronic Kidney Disease I: Introduction
01:18Chronic Kidney Disease IV: Nursing Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Diabetic Nephropathy