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Updated: Dec 24, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Associations between estimated glomerular filtration rate and cardiac biomarkers
Lu Pang1, Zhe Wang1, Zi-Long Zhao2
1Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
Insights
Reduced kidney function in adults is linked to higher levels of cardiac biomarkers like cTnI and HBDH, complicating CVD diagnosis. This association was not observed in children, suggesting different pathophysiological mechanisms.
Area of Science:
- Nephrology and Cardiology
- Biomarker Analysis
- Renal Dysfunction Impact
Background:
- Chronic kidney disease (CKD) significantly elevates cardiovascular disease (CVD) mortality risk.
- Cardiac biomarker elevation in renal dysfunction presents diagnostic challenges for CVD.
- Understanding the interplay between eGFR and cardiac biomarkers is crucial.
Purpose of the Study:
- To investigate associations between estimated glomerular filtration rate (eGFR) and key cardiac biomarkers.
- To determine how renal dysfunction influences cardiac biomarker levels.
- To clarify diagnostic ambiguities in patients with CKD and potential CVD.
Main Methods:
- Cross-sectional analysis of 812 adults and 215 children.
- Assessed eGFR against cardiac troponin I (cTnI), CK, CK-MB, LDH, HBDH, and BNP.
- Employed Spearman correlation and logistic regression for association evaluation.
Main Results:
- In adults, lower eGFR correlated with elevated cTnI, CK-MB, LDH, HBDH, and BNP.
- Reduced eGFR (<60 mL/min/1.73 m²) was associated with significantly higher cTnI and HBDH in adults.
- In children, lower eGFR (<90 mL/min/1.73 m²) did not show significant associations with elevated CVD biomarkers.
Conclusions:
- Reduced eGFR is associated with elevated cardiac troponin I and hydroxybutyrate dehydrogenase in adults without overt CVD.
- The impact of renal dysfunction on cardiac biomarkers differs between adult and pediatric populations.
- Findings highlight the need for careful interpretation of cardiac biomarkers in CKD patients.
Background:
Chronic kidney disease (CKD) is associated with an increased cardiovascular disease (CVD) mortality risk. Elevation of cardiac biomarkers in patients with renal dysfunction is ambiguous in the diagnosis of CVD. The purpose of this study was to investigate the associations between estimated glomerular filtration rate (eGFR) and cardiac biomarkers, and the influence of renal dysfunction on the cardiac biomarkers.
Methods:
We examined the cross-sectional associations of eGFR with cardiac troponin I (cTnI), creatine kinase (CK), CK-MB, lactic dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), and brain natriuretic peptide (BNP) in 812 adults and 215 child. Spearman correlation and logistic regression analysis were performed to evaluate the associations.
Results:
For adults, lower eGFR CKD-EPI had significantly higher cTnI, CK-MB, LDH, HBDH, and BNP. There were negative correlations between eGFRCKD-EPI and cTnI, CK-MB, LDH, HBDH, and BNP. After adjustment for potential confounders, as compared with eGFRCKD-EPI ≥ 90 mL/min/1.73 m2 , eGFRCKD-EPI < 60 mL/min/1.73 m2 remained associated with a 2.83 (1.08-7.41) [ratio (95% CI)] times higher cTnI and a 6.50 (2.32-18.22) [ratio (95% CI)] times higher HBDH. For child, lower eGFRSchwartz had significant higher CK and CK-MB. There were negative correlations between eGFRSchwartz and CK, and eGFRSchwartz and CK-MB. After adjustment for potential confounders, as compared with eGFRSchwartz ≥ 90 mL/min/1.73 m2 , eGFRSchwartz < 90 mL/min/1.73 m2 revealed no significant higher CVD biomarkers.
Conclusion:
Reduced eGFR is associated with elevated cTnI and HBDH among adults without clinically evident CVD, but not child.
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