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Updated: Mar 28, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Creatine-kinase and dialysis patients, a helpful tool for stratifying cardiovascular risk?
Borja Quiroga1, Almudena Vega1, Soraya Abad1
1Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Insights
Creatine kinase MB isoenzyme (CK-MB) effectively predicts cardiovascular events in hemodialysis patients. This cardiac biomarker improves cardiovascular risk stratification, offering valuable prognostic information for this high-risk population.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Patients undergoing hemodialysis face elevated cardiovascular event risks.
- Cardiac biomarkers aid in risk stratification, but the prognostic value of creatine kinase MB isoenzyme (CK-MB) remains unvalidated in this group.
Purpose of the Study:
- To determine the predictive value of CK-MB for cardiovascular events in hemodialysis patients.
- To assess if CK-MB improves cardiovascular risk prediction models in this population.
Main Methods:
- A cohort of 211 hemodialysis patients was followed for a median of 39 months.
- Baseline cardiac biomarkers, including CK-MB, were recorded.
- Factors associated with CK-MB and its prognostic value for cardiovascular events were analyzed.
Main Results:
- Median CK-MB levels were 1 ng/mL, with no patient exceeding normal limits.
- Higher CK-MB levels were associated with pre-existing heart disease, diabetes, and cardiac dysfunction.
- CK-MB levels ≥2 ng/mL were independently linked to cardiovascular events.
- Incorporating CK-MB into risk models improved cardiovascular event prediction by 17% (IDI).
Conclusions:
- CK-MB serves as a valuable marker for cardiovascular risk stratification in hemodialysis patients.
- CK-MB provides additional prognostic information beyond established predictors of cardiovascular events.
Background And Aims:
Hemodialysis patients have an enhanced risk for cardiovascular events. Cardiac biomarkers provide useful information for stratifying their risk. However the prognosis value of creatine kinase MB isoenzyme (CKMB) has not yet been validated in this population. The aim of the present study is to determine the predictable value of CK-MB in hemodialysis.
Methods:
A cohort of 211 hemodialysis patients (58.3% male, median age 73 (60-80) years) were followed for 39 (19-56) months. Cardiac biomarkers including CKMB were recorded at baseline. Factors associated to CKMB and prognosis value of this biomarker was studied.
Results:
The median value of CKMB was 1 (1-2) ng/mL with no patient exceeding normal laboratory values. Previous heart disease, diabetes mellitus, peripheral vascular disease and systolic and diastolic dysfunction were associated with higher levels of CKMB. Ninety-four patients (44.5%) cardiovascular events were recorded. CKMB levels ≥2ng/mL was independently associated to cardiovascular events during the follow up after adjusting. Adding CKMB to a model including several variables for predicting cardiovascular events, resulted in 17% improvement in risk discrimination (IDI) with a relative IDI of 9.9% (p=0.04).
Conclusions:
CKMB is a good marker for stratifying cardiovascular risk in hemodialysis patients and adds prognosis information to other well known independent predictors for cardiovascular events.
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