Prevalence of elevated troponin I in end-stage renal disease patients receiving hemodialysis.
OBJECTIVE
Patients with end-stage renal disease (ESRD) who are receiving hemodialysis have an increased incidence of atherosclerotic heart disease. Currently, there is considerable controversy regarding the significance of elevated cardiac troponin I (cTnI) levels in patients with ESRD. The objective of this study was to examine the prevalence of elevated cTnI levels in asymptomatic patients with ESRD on hemodialysis.


METHODS
This was a prospective cohort study at an urban hospital outpatient dialysis center. Serum was collected pre- and postdialysis from patients on dialysis at this center over a two-week period. Samples were batched and analyzed for cTnI using the Asxym fluorescent antibody test. An elevated cTnI level was defined as >0.8 ng/dL.


RESULTS
Predialysis cTnI levels ranged from <0.1 to 0.7 ng/dL, and postdialysis cTnI levels ranged from <0.1 to 0.6 ng/dL. None of the patients had a cTnI level >0.8 ng/dL.


CONCLUSIONS
cTnI levels are not falsely elevated in patients with ESRD on hemodialysis. In a patient with ESRD, myocardial injury should be suspected if his or her cTnI level is >0.8 ng/dL.
Donnino
Michael W
MW
Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA. mdonnino@aol.com
Karriem-Norwood
Varnada
V
Rivers
Emanuel P
EP
Gupta
Ajay
A
Nguyen
H Bryant
HB
Jacobsen
Gordon
G
McCord
James
J
Tomlanovich
Michael C
MC
D000328:Adult; D000368:Aged; D015415:Biomarkers; D003327:Coronary Disease / Q000097:blood / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I