title: Effects of hemoperfusion on serum cardiac troponin T concentrations using polymyxin B-immobilized fibers in septic patients undergoing hemodialysis.
abstract: We investigated whether serum cardiac troponin T levels are altered in septic patients undergoing hemodialysis and whether polyinyxin B-immobilized fiber (PMX-F) treatment affects these levels. Fourteen heinodialysis patients with sepsis, 14 hemodialysis patients without sepsis, and 12 age matched healthy controls were included in this study. Cardiac troponin T levels in hemodialysis patients with sepsis (0.56+/-0.28 microg/L) were higher than levels in hemodialysis patients without sepsis (0.16+/-0.06 microg/L, p < 0.01) and healthy control subjects (0.03+/-0.01 microg/L, p < 0.001). The 14 hemodialysis patients with sepsis were randomly assigned to one of two treatment approaches: PMX-F treatment (n = 7) or conventional treatment (n = 7). Plasma endotoxin levels were significantly reduced from 46.6+/-17.8 pg/mI to 8.2+/-2.4 pg/ml, p < 0.01, in patients treated with PMX-F, and serum cardiac troponin T levels were also reduced from 0.62+/-0.30 microg/L to 0.26 = 0.12 microg/L, p < 0.05. Cardiac troponin T levels were unchanged in patients under conventional treatment. These data suggest that cardiac troponin T is indeed elevated in septic patients undergoing hemodialysis and niay reflect subclinical myocardial cell damage. PMX-F is effective in reducing myocardial damage, in part, due to reducing plasma endotoxin levels.
authors.affiliation: Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.forename: Chifuyu
authors.initials: C
authors.lastname: Ushiyama
authors.forename: Hisataka
authors.initials: H
authors.lastname: Shoji
authors.forename: Hikaru
authors.initials: H
authors.lastname: Koide
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004731:Endotoxins / Q000097:blood; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011112:Polymyxin B / Q000627:therapeutic use; D006435:Renal Dialysis; D018805:Sepsis / Q000097:blood* / Q000188:drug therapy; D020107:Troponin T / Q000097:blood*
chemical_list: D000900:Anti-Bacterial Agents; D004731:Endotoxins; D020107:Troponin T; D011112:Polymyxin B