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Cardiac troponins in patients with renal dysfunction
P O Collinson1, L Hadcocks, Y Foo
1Department of Chemical Pathology, Mayday University Hospital, London, UK.
Annals of Clinical Biochemistry
|June 23, 1998
Summary
Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are often detectable in patients with renal dysfunction. Serial measurements may be needed to diagnose acute coronary syndromes in this population.
Area of Science:
- Cardiology
- Nephrology
- Clinical Chemistry
Background:
- Renal dysfunction can affect cardiac biomarker levels.
- Accurate diagnosis of acute coronary syndromes (ACS) is challenging in patients with kidney disease.
Purpose of the Study:
- To investigate the detectability and frequency of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in patients with varying degrees of renal dysfunction.
- To assess the correlation of troponin levels with other renal and cardiac markers.
Main Methods:
- Measured cTnT and cTnI in 198 patients with renal dysfunction using ELISA, Enzymun, OPUS plus, and OPUS Magnum systems.
- Classified patients into chronic renal impairment (CRI), chronic renal failure (CRF), acute renal failure (ARF), and hemodialysis (HD) groups.
Main Results:
- Cardiac troponins were detectable in a significant proportion of patients with renal dysfunction.
- cTnT and cTnI were more frequently detected in CRF, HD, and ARF groups compared to the CRI group.
- Troponin concentrations did not correlate with serum creatine kinase (CK), CK-MB, urea, or creatinine.
Conclusions:
- Cardiac troponins are frequently detectable in patients with renal dysfunction.
- Serial troponin measurements are crucial for diagnosing ACS in patients with renal impairment due to potential elevations unrelated to acute cardiac events.