title: The effect of hemodialysis on cardiac enzyme levels and echocardiographic parameters.
abstract: BACKGROUND
  Cardiac troponins are specific and sensitive markers of myocardial damage. Troponin levels may increase without an obvious active cardiac disease in hemodialysis patients. In this study, we aimed to investigate the effect of a single hemodialysis session on echocardiographic parameters and cardiac enzyme levels, including cTn-I, creatine phosphokinase (CPK), and creatine kinase-MB (CK-MB).
  
  
  METHODS
  Forty patients under chronic hemodialysis treatment enrolled in this prospective study. All the patients had a physical examination and underwent echocardiography before and after hemodialysis. cTn-I, CPK and CK-MB levels were also determined before and after hemodialysis in all patients.
  
  
  RESULTS
  Post-dialysis cTn-I levels were significantly higher compared to pre-dialysis levels (p = 0.03). cTn-I levels increased in 26 patients, did not change in 1 patient and decreased in 13 patients after hemodialysis when compared to the values determined before hemodialysis. There was no significant increase in CPK and CK-MB levels after dialysis. Statistically significant changes were detected in the end-systolic diameter of the left ventricle, end-diastolic diameter of left ventricle, ejection fraction, diameter of the left atrium, diameter of the right atrium, pulmonary artery pressure and end-diastolic diameter of the right ventricle. However, there was no significant relation between these echocardiographic changes and ultrafiltration volume, blood flow rate, age, and gender.
  
  
  CONCLUSIONS
  Hemodialysis leads to an increase in cTnI levels. However, the effect of increased cTnI levels on survival rates in hemodialysis patients with underlying coronary artery disease has not yet been determined. Prospective multi-center studies with large sample size are required to clarify this issue.
authors: 1 Department of Nephrology, School of Medicine, Harran University, Sanliurfa - Turkey.
authors: Muharrem
authors: M
authors: Ingec
authors: Ebru Gok
authors: EG
authors: Oguz
authors: Tolga
authors: T
authors: Yildirim
authors: Turgay
authors: T
authors: Ulas
authors: Mehmet
authors: M
authors: Horoz
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000201:enzymology* / Q000628:therapy*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form