title: Serum levels of cardiac enzymes before and after renal transplantation.
abstract: BACKGROUND
  Cardiac troponins are very sensitive and specific indicators of myocardial damage; however, they are sometimes found to be increased in patients with end-stage renal disease (ESRD).
  
  
  OBJECTIVE
  The aim of this study was to determine cardiac troponin I (cTpI) and creatine kinase myocardial isoform (CK-MB) levels and to assess their diagnostic and prognostic importance before and after renal transplantation.
  
  
  METHODS
  Thirty-four patients with ESRD (mean age 31.8 +/- 8.6 years, 11 women) were enrolled. Serum levels of cTpI and CK-MB were measured pre- and postoperatively on Days 1, 7, and 30. Patients were followed up for cardiac events, and possible myocardial damage was investigated by exercise thallium-201-labeled myocardial perfusion scintigraphy. Mean cTpI levels were 0.24 +/- 0.11 ng/ml (preoperative), and 0.34 +/- 0.27 ng/ml (Day 1), 0.26 +/- 0.11 ng/ml (Day 7), and 0.28 +/- 0.30 ng/ml (Day 30).
  
  
  RESULTS
  Compared with preoperative levels, cTpI was increased in 16 (47%), decreased in 6 (17.6%), and did not change in 12 (35.4%) patients. However, the increase did not exceed the myocardial infarction reference level of 2.3 ng/ml in any patient. Mean CK-MB levels were 12.6 (8.7U/l (preoperative), and 16.8 +/- 9.2U/l (Day 1), 16.3 +/- 8.1U/l (Day 7), and 13.3 +/- 6.6U/l (Day 30). Creatine kinase-MB was increased to above normal levels of 24 U/l in 13 (38.2%) patients on postoperative Days 1 or 7, and decreased to normal at the end of Month 1. No cardiac events occurred, and there was no abnormality in any patient on thallium scintigraphy.
  
  
  CONCLUSIONS
  There was no significant difference in the levels of cTpI in patients with ESRD without cardiac events before and after renal transplantation (p > 0.05). Our findings show that cTpI has very high sensitivity and specificity for detecting cardiac damage in patients with ESRD after renal transplantation.
authors.affiliation: Department of Cardiology, Baskent University, School of Medicine, Ankara, Turkey. mdhbozbas@yahoo.com
authors.forename: Huseyin
authors.initials: H
authors.lastname: Bozbas
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Korkmaz
authors.forename: Ilyas
authors.initials: I
authors.lastname: Atar
authors.forename: Serpil
authors.initials: S
authors.lastname: Eroglu
authors.forename: Bülent
authors.initials: B
authors.lastname: Ozin
authors.forename: Aylin
authors.initials: A
authors.lastname: Yildirir
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
authors.forename: Turan
authors.initials: T
authors.lastname: Colak
authors.forename: Hamdi
authors.initials: H
authors.lastname: Karakayali
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D015425:Myocardial Reperfusion; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form