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Cardiac biomarkers in dialysis

Usman Mahmood1, David W Johnson1,2,3, Magid A Fahim1,2,3

  • 1Department of Nephrology, Princess Alexandra Hospital, Australia.

AIMS Genetics
|August 23, 2019
PubMed

Insights

Cardiovascular disease is a leading cause of death in dialysis patients. This review explores cardiac biomarkers like Brain Natriuretic peptide (BNP), N-terminal pro-Brain Natriuretic peptide (NT-proBNP), troponins, ST2, and galectin-3 for early diagnosis and risk assessment.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarker Research

Background:

  • Cardiovascular disease (CVD) is the primary cause of mortality in patients undergoing dialysis, accounting for ~40% of deaths.
  • Effective cardiovascular risk stratification is crucial for optimizing therapeutic interventions and reducing morbidity and mortality in this population.
  • Biomarkers offer a promising avenue for early detection of cardiac injury and timely intervention.

Purpose of the Study:

  • To review the current evidence on the utility of cardiac biomarkers in diagnosing myocardial injury.
  • To discuss the role of cardiac biomarkers in monitoring the risk of major adverse cardiovascular events (MACE) in dialysis patients.

Main Methods:

  • Literature review of studies investigating cardiac biomarkers in hemodialysis and peritoneal dialysis patients.
  • Focus on established biomarkers (BNP, NT-proBNP, troponins) and emerging biomarkers (ST2, galectin-3).

Main Results:

  • Established biomarkers like BNP, NT-proBNP, and troponins are validated predictors of mortality in dialysis patients.
  • Emerging biomarkers, including ST2 and galectin-3, show potential for risk stratification in both general and dialysis populations.
  • Cardiac biomarkers aid in the early diagnosis of myocardial injury and risk assessment for MACE.

Conclusions:

  • Cardiac biomarkers are essential tools for managing cardiovascular risk in dialysis patients.
  • Utilizing a panel of biomarkers may enhance the accuracy of risk stratification and guide clinical decision-making.
  • Further research into novel biomarkers could improve cardiovascular outcomes in patients on dialysis.

Keywords:
BiomarkersCardiovascular diseaseChronic kidney diseaseDialysisGalectinHemodialysisN-terminal pro-B-type natriuretic peptideNatriuretic peptideSuppression of tumorigenicity 2Troponinbrain

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