title: Cardiac troponin levels in asymptomatic patients on the renal transplant waiting list.
abstract: OBJECTIVE
  Cardiac troponin levels predict mortality and cardiovascular events in asymptomatic patients receiving dialysis and may be a useful clinical tool to stratify high-risk asymptomatic individuals.
  
  
  METHODS
  The present study examined levels of troponins I (cTnI) and T (cTnT) in patients with chronic renal impairment, patients receiving dialysis and renal transplant recipients. Patients receiving dialysis on the renal transplant waiting list were compared with those excluded from the list based on medical criteria. Median levels were compared using the Kruskal-Wallis test and proportions compared by chi-squared.
  
  
  RESULTS
  Median troponin levels were higher in patients on dialysis than transplant recipients. Comparing patients receiving dialysis not listed compared with those listed for renal transplant, median cTnI levels were significantly higher (0.03 versus 0.02 microg/L, P < 0.01) whereas median cTnT levels were not. Patients listed for transplantation were younger, had less clinical cardiovascular disease and lower C-reactive protein than those awaiting renal transplantation. The proportion of patients with elevated cTnT was not substantially different between patients awaiting renal transplantation (38%) and those excluded (52%). Levels of cTnI and cTnT were inversely related to renal function in predialysis and transplant patients, but were not related to time on dialysis for those receiving dialysis therapy.
  
  
  CONCLUSIONS
  As patients awaiting renal transplantation are clinically screened for cardiovascular disease but have frequently elevated cardiac troponin levels, troponin may be a useful clinical tool to identify high-risk asymptomatic patients on dialysis prior to renal transplantation. The influence of renal function on the interpretation of cardiac troponin and risk prediction requires further evaluation.
authors.affiliation: Department of Nephrology, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Roberts
authors.forename: Neil
authors.initials: N
authors.lastname: MacMillan
authors.forename: David L
authors.initials: DL
authors.lastname: Hare
authors.forename: Sujiva
authors.initials: S
authors.lastname: Ratnaike
authors.forename: Ken
authors.initials: K
authors.lastname: Sikaris
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Fraenkel
authors.forename: Francesco L
authors.initials: FL
authors.lastname: Ierino
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*; D014850:Waiting Lists
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T