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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Published on: February 2, 2021

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[Troponins and chronic kidney disease]

Luca Di Lullo, Vincenzo Barbera, Alberto Santoboni

    Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
    |August 8, 2015
    PubMed

    Insights

    High-sensitivity cardiac troponin (hs-cTn) assays present challenges in diagnosing acute myocardial infarction (AMI) in chronic kidney disease (CKD) patients due to elevated baseline levels. This review examines hs-cTn utility for AMI diagnosis and prognosis in CKD.

    Area of Science:

    • Cardiology
    • Nephrology
    • Biomarker Research

    Background:

    • Coronary thrombosis has a long history, with acute myocardial infarction (AMI) distinguished from angina pectoris in 1912.
    • Diagnostic tools evolved from ECG and basic labs to cardiac enzymes and finally troponins, with high-sensitivity assays emerging in 2010.
    • Chronic kidney disease (CKD) patients face increased cardiovascular risk, complicating the interpretation of cardiac troponin levels.

    Purpose of the Study:

    • To review the diagnostic role of high-sensitivity cardiac troponin (hs-cTn) in patients with CKD for acute myocardial infarction (AMI).
    • To evaluate the prognostic significance of elevated hs-cTn levels in CKD patients without AMI.

    Main Methods:

    • Literature review focusing on hs-cTn assays in CKD populations.
    • Analysis of studies investigating hs-cTn for AMI diagnosis in CKD.
    • Examination of research on hs-cTn as a prognostic marker in CKD patients without AMI.

    Main Results:

    • Elevated baseline hs-cTn levels are common in CKD patients, posing interpretation challenges for AMI diagnosis.
    • hs-cTn assays require careful consideration in CKD for accurate AMI detection.
    • Elevated hs-cTn levels in CKD patients without AMI may hold prognostic value for cardiovascular events.

    Conclusions:

    • The interpretation of hs-cTn in CKD requires specific strategies to differentiate AMI from other causes of troponin elevation.
    • hs-cTn assays are valuable tools, but their application in CKD necessitates a nuanced approach for both diagnosis and prognosis.

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