Predictive markers of asymptomatic atherosclerosis in end-stage renal disease patients.
OBJECTIVE
Uremia is associated with accelerated atherosclerosis and increased cardiovascular mortality in patients with end-stage renal disease (ESRD). Cardiac injury markers, such as myoglobin, creatine kinase-MB (CK-MB), or troponins, frequently used to recognize acute coronary events, may be falsely elevated in this patient group. In this study, our aim was to (i) test serum levels of myoglobin, CK-MB, and troponin I (cTnI) in ESRD patients without coronary artery disease (CAD) and compare the results with healthy controls and (ii) to investigate the association between these markers and carotid artery intima-media thickness (CA-IMT), high-sensitive C-reactive protein (hs-CRP), and serum uric acid (SUA) levels in ESRD patients.


METHODS
Fifty-two ESRD patients (25 hemodialysis and 27 peritoneal dialysis) and 17 healthy controls were included in the study. Serum levels of myoglobin, CK-MB, and cTnI were measured and ultrasonographic CA-IMT was determined in all participants. SUA and hs-CRP levels were only measured in the ESRD group.


RESULTS
Serum myoglobin, CK-MB levels, and the mean CA-IMT were significantly higher in ESRD group (p < 0.01), whereas cTnI levels were not different compared to healthy controls (p = 0.70). There was also a positive correlation between CA-IMT and cTnI levels (p = 0.003, r = 0.35) and CA-IMT and hs-CRP (p = 0.03, r = 0.30) or SUA levels (p = 0.003, r = 0.43).


CONCLUSIONS
cTnI may serve as a more sensitive marker in detecting cardiovascular events in patients with renal failure. Besides the traditional risk factors of atherosclerosis, cTnI, hs-CRP, and SUA may have a predictive role in recognizing premature atherosclerosis in ESRD patients.
Mutluay
Rüya
R
Department of Nephrology, Gazi University Hospital, 06100, Ankara, Turkey.
Konca
Ceyla
C
Erten
Yasemin
Y
Paşaoğlu
Hatice
H
Değer
Serpil Müge
SM
Ağirgün
Cağri
C
Derici
Ulver
U
Arinsoy
Turgay
T
Sindel
Sükrü
S
D000704:Analysis of Variance; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D009211:Myoglobin; D019210:Troponin I; D052279:Creatine Kinase, MB Form