title: The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB) in detecting combined renal and myocardial injuries in asphyxiated infants.
abstract: BACKGROUND
  Troponin T (cTnT) and Creatinine Kinase Isoenzyme (CK-MB) are both markers of myocardial injuries. However, CK-MB is also elevated in acute kidney injury.
  
  
  OBJECTIVE
  The diagnostic value of both cTnT and cardiac CK-MB in combined myocardial and acute kidney injuries (AKI) in asphyxiated neonates was evaluated.
  
  
  METHODS
  40 asphyxiated infants and 40 non-asphyxiated controls were consecutively recruited. Serum levels of cTnT, CK-MB and creatinine were measured. Myocardial injury and AKI were defined as cTnT >95th percentile of the control and serum creatinine >1.0 mg/dl respectively.
  
  
  RESULTS
  Of the 40 subjects, 9 (22.50%), 8 (20.00%) and 4 (10.00%) had myocardial injury, AKI and combined AKI and myocardial injuries respectively. The mean cTnT and CK-MB values were highest in infants with combined AKI and myocardial injuries. The Mean cTnT in infants with AKI, myocardial injury and combined AKI and myocardial injuries were 0.010±0.0007 ng/ml, 0.067±0.040 ng/ml and 0.084±0.067 ng/ml respectively, p = 0.006. The mean CK-MB in infants with AKI, myocardial injury and combined AKI and myocardial injuries were 2.78±0.22 ng/ml, 1.28±0.11 ng/ml and 4.58±0.52 ng/ml respectively, p = <0.0001.
  
  
  CONCLUSIONS
  In severe perinatal asphyxia, renal and myocardial injuries could co-exist. Elevated cTnT signifies the presence of myocardial injury. Elevated CK-MB indicates either myocardial injury, AKI or both. Therefore renal injury should be excluded in asphyxiated infants with elevated CK-MB.
authors.affiliation: Department of Child Health, University of Benin/University of Benin Teaching Hospital, Benin City, Nigeria.
authors.forename: Wilson E
authors.initials: WE
authors.lastname: Sadoh
authors.affiliation: Institute of Child Health, University of Benin/University of Benin Teaching Hospital, Benin City, Nigeria.
authors.forename: Charles O
authors.initials: CO
authors.lastname: Eregie
authors.affiliation: Institute of Child Health, University of Benin/University of Benin Teaching Hospital, Benin City, Nigeria.
authors.forename: Damian U
authors.initials: DU
authors.lastname: Nwaneri
authors.affiliation: Institute of Child Health, University of Benin/University of Benin Teaching Hospital, Benin City, Nigeria.
authors.forename: Ayebo E
authors.initials: AE
authors.lastname: Sadoh
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications; D016022:Case-Control Studies; D052279:Creatine Kinase, MB Form / Q000097:blood*; D003404:Creatinine / Q000097:blood; D005260:Female; D006335:Heart Injuries / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000150:complications / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T; D003404:Creatinine; D052279:Creatine Kinase, MB Form