Difficult interpretation of the concentration of cardiac markers in dialyzed patients – case report
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Z Katedry i Zakładu Medycyny Rodzinnej Uniwersytetu Medycznego w Lublinie
Med Og. 2010;16(3):366–371
Increase in the concentration of cardiac troponins is among the most reliable biochemical markers of acute ischemic heart diease. Chronically elevated concentration of troponins among dialyzed patients, without simultaneous presence of acute ischemia, is a commonly observed phenomenon. This causes difficulties in interpretation of the results obtained which, in some cases, lead to the misdiagnosis of the myocardial infarction in this special population of patients.
Apple F., Murakami M., Pearce L. et al.: Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and cardiac troponin T and I in end-stage renal disease for all-cause death. Clin Chem 2004, 50, 2279-2285.
Conway B., Mc Laughlin M., Sharpe P. et al.: Use of cardiac troponin T in diagnosis and prognosis of cardiac events in patients on chronic haemodialysis. Nephrol Dial Transplant 2005; 20: 2759–2764.
Duman D., Tokay S., Toprak A. et al.: Elevated cardiac troponin T is associated with increased left ventricular mass index and predicts mortality in continuous ambulatory peritoneal dialysis patients. Nephrol Dial Transplant 2005, 20, 962-967.
Filippi C., Wasserman S., Rosanio S. et al.: Cardiac troponin T and C-reactive protein for predicting prognosis, coronary atherosclerosis, and cardiomyopathy in patients undergoing long-term hemodialysis. JAMA 2003, 290, 353-359.
Hayashi T, Obi Y, Kimura K.: Cardiac troponin T predicts occult coronary artery stenosis in patients with chronic kidney disease at the start of renal replacement therapy. Nephrol Dial Transplant 2008, 23, 2936-2942.
Hojs R., Ekart R., Hojs Fabjan T. et al.: Cardiac troponin T (cTnT) in hemodialysis patients with asymptomatic and symptomatic atherosclerosis. Arch Med Res 2005, 36, 367-71.
Jaroszyński A., Załuska W., Bober E. et al.: Factors producing increase of QRS complex amplitude during hemodialysis. Przegl Lek 2005, 62, 270-273.
Kanderian A., Francis G.: Cardiac troponins and chronic kidney disease. Kidney Int 2006, 69, 1112-1114.
Marcinkowska E., Flisiński M., Manitius J.: Znaczenie diagnostyczne i prognostyczne troponin w przewlekłej chorobie nerek. Pol Merk Lek 2007, 137, 375-381.
Montagnana M., Lippi G., Tessitore N. et al.: Effect of hemodialysis on traditional and innovative cardiac markers. J Clin Lab Anal 2008, 22, 59-65.
Parikh S., de Lemos J., Jessen M. et al.: Timing of in-hospital coronary artery bypass graft surgery for non-ST-segment elevation myocardial infarction patients results from the National Cardiovascular Data Registry ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines). JACC Cardiovasc Interv 2010, 3, 419-427.
Sarnak M., Levey A., Schoolwerth A. et al.: Kidney disease as a risk factor for development of cardiovascular disease. A statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation 2003, 108, 2154-2169.
Sommerer C., Giannitis E., Schwenger M.: Cardiac Biomarkers in haemodialysis patients: The prognostic value of amino-terminal pro-B-type natriuretic peptide and cardiac troponin T. Nephron Clin Pract 2007, 107, 77-81.
Wang A., Wai-Kei Lam C., Wang M. et al.: Prognostic value of cardiac troponin T is independent of inflammation, residual renal function, and cardiac hypertrophy and dysfunction in peritoneal dialysis patients. Clini Chem 2007, 53, 882–889.
Wrenn K., Blair R., Par lF. et al.: Calcium-phosphorus product and troponin-T values in renal failure. Am J Emerg Med 2006, 24, 836-388.
Wu A., Ford L.: Release of cardiac troponin in acute coronary syndromes: ischemia or necrosis? Clin Chim Acta 1999, 284, 161-174.