Changes in high sensitivity troponin T in incident haemodialysis patients

To characterise the changes in high sensitivity troponin T (hsTnT) in incident haemodialysis patients.

Previous studies had shown that stable chronic haemodialysis patients have elevated cardiac troponin compared to the general population. Cardiac troponin on incident haemodialysis patients had not been characterised.

This prospective descriptive study included all patients who started haemodialysis in Auckland City Hospital over 18 months. A troponin level was measured prior to the commencement of their first haemodialysis session and regular pre-dialysis troponin levels are measured every two to four months. Each patient has two to four troponin measurements during the study with a minimum follow-up of six months.

A total of 91 patients started on haemodialysis during this period. Fifty-five patients had two troponin measurements and 40 of these patients had four troponin measurements. The baseline median troponin level prior to commencement of dialysis was 91ng/L (54-191ng/L) and declined with subsequent measurements. There was a significant decrease in the 3rd and 4th troponin measurements compared to baseline troponin. The baseline troponin levels were not independently associated with mortality. The decrease in troponin levels did not correlate with a decline in weight.

This is the first study to describe and show a decline in cardiac troponin post-initiation of haemodialysis. The baseline troponin measurements were not predictive of mortality.