Comparison of Troponin-I Levels Before and After Haemodialysis in Diabetic and Nondiabetic Chronic Kidney Disease Patients

Year 2012, Volume: 14 Issue: 3, 11 - 14, 01.12.2012

Gökhan Apucu Fatma Paksoy Mehmet Sinan Dal İlhan Hacıbekiroğlu Tamer Sakacı Fatih Borlu Abdurrahman Yurtaslan Turgay Ulaş

Abstract

Objective: Cardiac troponin levels may be elevated despite the absence of acute coronarysyndrome in patients with chronic renal failure. In this study, diabetic and nondiabetic end stagerenal disease patients were compared whether dialysis causes myocardial damage or not byanalysing troponin-I levels.Methods: In this study, 80 patients (57 men and 23 women) without coronary artery diseasewere investigated. The patients were divided into two groups; 62,5% of patients (n=50) werediabetic and 37,5% (n=30) of patients were nondiabetic. Troponin-I levels (before and after thehaemodialysis) were analysed in all patients.Results: The avarage of troponin-I levels in all patients were 0,0234±0,0169 ng/ml before thehaemodialysis and 0,0345±0,549 ng/ml after the haemodialysis. A statistically significantdifference were found between the levels of cTn-I before and after haemodialysis (p

Keywords

Diabetes mellitus, hemodialysis, troponin-I

Diyabetik ve Nondiyabetik Kronik Böbrek Yetersizliği Hastalarında Hemodiyaliz Öncesi ve Sonrası Troponin-I Düzeylerinin Karşılaştırılması

Abstract

Amaç: Kronik böbrek yetersizliği olan hastalarda troponin değerleri klinik olarak akut koronersendrom dışı durumlarda da yüksek bulunabilmektedir. Yapılan bu çalışmada, diyabetik venondiyabetik son dönem böbrek yetersizliği hastalarında hemodiyaliz öncesi ve sonrası troponinI değerleri bakılarak, diyalizin myokardial hasara neden olup olmadığı araştırıldı.Gereç ve yöntem: Çalışmaya bilinen koroner arter hastalığı olmayan 57’si erkek ve 23’ü kadıntoplam 80 hasta alındı. Çalışma grubu 50(%62,5) nondiyabetik ve 30(%37,5) hasta diyabetikhastalardan oluşturuldu. Tüm hastalarda troponin-I düzeyi (hemodiyaliz öncesi ve sonrasında)bakıldı.Bulgular: Tüm hastalarda herhangi bir gruba ayrılmadan bakılan troponin-I düzeylerininortalama değerleri, hemodiyaliz öncesi troponin-I ortalaması 0,0234±0,0169 ng/ml, hemodiyalizsonrası troponin-I ortalaması 0,0345±0,549 ng/ml olarak bulundu. Hemodiyaliz öncesi vesonrası troponin-I değerleri arasındaki fark anlamlı bulundu (p

Keywords

Diyabetes mellitus, hemodiyaliz, troponin-I

References

• Tanrıverdi MH, Karadağ A, Hatipoğlu ES. Chronic kidney disease. Konuralp Tıp Dergisi 2:27-32, 2010.
• Zoccali C, Mallamaci F, Tripepi G. Traditional and emerging risk factors in end-stage renal disease. Kidney Int Suppl 63:105-110, 2003.
• McCann VJ, Knuiman MW, Stanton KG, Winter MG. Mortality and coronary heart disease in diabetes mellitus. Aust J Public Health. 18:92-95, 1994.
• Mc Laurin MD, Apple FS, Voss EM, Herzog CA, Sharkey SW: Cardiac troponin-I, cardiac troponin-T, and creatinin kinase MB in dialysis patients without ischemic heart disease: evidence of cardiac troponin-T expression in skelatal muscle. Clin Chem 43:976-982, 1997.
• Roppolo LP, Fitzgerald R, Dillow J, Ziegler T, Rice M, Maisel A. A comparison of troponin T and Troponin I as predictors of cardiac events in patients undergoing chronic dialysis at a Veteran's hospital: a pilot study. J Am Coll Cardiol 34:448- 454, 1999.
• Tun A, Khan IA, Win MT, et al. Specificity of cardiac troponin I and creatine kinase- MB isoenzyme in asymptomatic long- term hemodialysis patients and effect of hemodialysis on these cardiac markers. Cardiology 90:280-285, 1998.
• Frankel WL, Herold DA, Ziegler TW, Fitzgerald RL. Cardiac troponin T is elevated in asymptomatic patients with chronic renal failure. Am J Clin Pathol 106:118-123, 1996.
• Fredericks S, Chang R, Gregson H, et al. Circulating cardiac troponin-T in patients before and after renal transplantation. Clin Chim Acta 310:199-203, 2001.
• Bodor GS, Porterfield D, Voss EM, Smith S, Apple FS. Cardiac troponin-I is not expressed in fetal and health or diseased adult human skeletal muscle tissue. Clin Chem 41:1710- 1715, 1995.
• Davis GK, Labugger R, Van Eyk JE, Apple FS. Cardiac troponin T is not detected in Western Blot of diseased renal tissue. Clin Chem. 47:782-783, 2001.
• Adams JE, Bodor GS, Davila-Roman VG et al. Cardiac troponin I. A marker with high spesifity for cardiac injury. Circulation 88:101-106, 1993.
• Bhayana V, Gougoulias T, Cohoe S, Henderson AR. Discordance between results for serum troponin T and troponin I in renal disease. Clin Chem 41:312-317, 1995.
• Lang K, Schindler S, Forberger C, Stein G, Figulla HR. Cardiac troponins have no prognostic value for acute and chronic cardiac events in asymptomatic patients with end- stage renal failure. Clin Nephrol 56:44-51, 2001.
• Ooi DS, Veinot JP, Wells GA, House AA. Increased mortality in hemodialyzed patients with elevated serum troponin T: A one-year outcome study. Clin Biochem 32:647-652, 1999.
• Freda BJ, Tang WH, Van Lente F, Peacock WF, Francis GS. Cardiac troponins in renal insufficiency: review and clinical implications. J Am Coll Cardiol 40:2065-2071, 2002.
• Ooi DS, Isotalo PA, Veinot JP. Correlation of antemortem serum creatine kinase, creatine kinase-MB, troponin I, and troponin T with cardiac pathology. Clin Chem 46:338-344, 2000.
• Farkouh ME, Robbins MJ, Zafar MU, et al. Association between troponin I levels and mortality in stable hemodialysis patients. Am J Med. 114:224-226, 2003.
• Rösen P, Du X, Tschöpe D. Role of oxygen derived radicals for vascular dysfunction in the diabetic heart: prevention by alpha-tocopherol?. Mol Cell Biochem. 188:103-111, 1998.
• Fava S, Azzopardi J, Agius-Muscat H. Outcome of unstable angina in patient with diabetes mellitus. Diabet med. 14:209- 213, 1997.