[Determining factors of cardiac biomarkers in hemodialysed diabetic and non-diabetic patients].
BACKGROUND
Cardiovascular diseases are highly prevalent in chronic renal failure patients, especially in diabetic population. Cardiac biomarkers such as pro-brain natriuretic peptide N-terminal piece (NT-proBNP), cardiac troponin T (cTnT) and high sensitive CRP (hs-CRP) are increasingly used for early detection.


OBJECTIVE
The authors analysed, which factors influence cardiac biomarker levels in hemodialysed patients and whether these factors depend on the presence of diabetes.


METHODS
In 28 diabetic and 40 non-diabetic patients on chronic hemodialysis was analysed the association between routine laboratory data, bioimpedance parameters, results of echocardiography and ambulatory blood pressure monitoring on cardiac biomarkers. Multivariate linear regression analysis (ANOVA) was applied for statistical evaluation.


RESULTS
The authors found stronger correlation (p = 0.034 vs. p = 0.001) between NT-proBNP and extracellular volume/total water volume hyperhydration ratio (ecv/twv) evaluated in diabetics than in non-diabetics. In case of cTnT, no relation was found with CaxP, iPTH, Kt/V, beta2-microglobulin, and serum uric acid levels. The hs-CRP was correlated with total cholesterol (p = 0.039) and EPO-dose (p = 0.03) in diabetics, while with serum fibrinogen (p = 0.025) in non-diabetics. The HbA1c didn't influence biomarkers in the diabetic group.


CONCLUSIONS
The factors having an impact on cardiac biomarker levels are similar in diabetic and non-diabetic hemodialysed patients. According to results the presence of end-stage renal disease in a cross-sectional survey probably overcomes the impact of diabetes and quality of glycaemic control on cardiac biomarker levels.
Mácsai
Emília
E
Diósgyori Kórház Belgyógyászat Miskolc. macsaim1@t-online.hu
Széll
Júlia
J
Ladányi
Erzsébet
E
Treszl
András
A
Vásárhelyi
Barna
B
Madácsy
László
L
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001834:Body Water; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D006435:Renal Dialysis; D012189:Retrospective Studies; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol