High sensitivity Troponin-I levels in asymptomatic hemodialysis patients

Figures & data

Table 1. Demographic and clinical characteristic data of non-CKD and HD groups.

	Non-CKD n = 107	HD n = 100	p-value
Age [mean, range (year)]	63.8 ± 9.97, 43–86	64.5 ± 13.8, 23–92	NS
Male gender [n (%)]	41 (38.3%)	44 (44%)	NS
Body weight (Kg)	62.4 ± 10.2	57.1 ± 12.8	NS
Co-morbid diseases [n (%)]
Diabetes mellitus	51 (47.7%)	49 (49%)	NS
Hypertension	78 (72.9%)	82 (82%)	NS
Cerebrovascular disease	3 (2.8%)	7 (7%)	NS
Coronary artery disease	9 (8.4%)	14 (14%)	NS
with PCI	6 (5.6%)	8 (8%)	NS

PCI: percutaneous coronary intervention.

Figure 1. The baseline of hsTnI in asymptomatic non-CKD group and pre-dialysis HD group as well as post-dialysis in HD group.

Table 2. Comparison between HD patients with post-dialysis hsTnI reduction and elevation subgroup.

	hsTnI reduction (N = 75)	hsTnI elevation (N = 25)	p value
Gender (Male)	30 (41%)	14 (56%)	NS
Age (year)	66.15 ± 12.9	59.80 ± 15.4	<.05
Body weight (kg)	55.76 ± 12.5	61.84 ± 12.9	<.05
Diabetes mellitus	36 (49%)	13 (52%)	NS
Hypertension	61 (82%)	21 (84%)	NS
History of stroke	5 (7%)	2 (8%)	NS
Ischemic heart disease	11 (15%)	3 (12%)	NS
History of percutaneous coronary intervention	6 (8%)	1 (4%)	NS
Clinical parameters
Systolic BP (mmHg)	158 ± 27	158 ± 17	NS
Diastolic BP (mmHg)	70 ± 15	71 ± 13	NS
Pulse (beats/min)	72 ± 13	70 ± 11	NS
Hemodialysis parameters
Dialysis vintage (years)	4.5 ± 5	4.8 ± 4.8	NS
Blood flow (mL/min)	352 ± 49	376 ± 38.5	<.05
Dialysate flow (mL/min)	701 ± 141	776 ± 83	<.05
Weight gain (%)	4.6 ± 2.2	4.7 ± 1.9	NS
Weight loss (%)	3.9 ± 1.5	4.1 ± 1.4	NS
Biochemical parameters
Pre-dialysis hsTnI (ng/L)	57.5 (26.2–157.3)	24 (10.2–141.4)	NS
Hematocrit (%)	33 ± 4.4	34 ± 3.4	NS
Hemoglobin (g/dL)	10.5 ± 1.2	11.1 ± 1.1	<.05
HbA1C (%)	5.7 ± 1.3	6.6 ± 2	NS
Cholesterol (mg/dL)	155 ± 34	159 ± 36	NS
Triglyceride (mg/dL)	107 ± 61	124 ± 65	NS
Albumin (g/dL)	3.8 ± 0.3	3.9 ± 0.4	NS

NS: not significant.

Table 3. Summary of studies of high sensitivity troponin-I level in asymptomatic chronic hemodialysis patients.

Authors (year, country)	Study design			HD modality in study group	Dialysis vintage (year)	Pre-dialysis hsTnI		Post-dialysis hsTnI
	Design	Study group (n)	Control group (n)			Level (ng/L)	Patients with elevated hsTnI (%)	Intra-dialytic changes	Subgroup of heighted hsTnI
Assa et al. [17] (2013, Netherlands)	prospective	90	no	Low-flux HD, BFR 250–300 mL/min	3.5 (IQR 1.5–5.5)	20 (IQR 11–38)	34%	Increase	66% of patients
Kumar et al. [14] (2011, USA)	prospective	51	no	High-flux HD, BFR: unavailable	unavailable	25 (range 0–461)	37%	Not significant (n = 49)	Not performed
Gaiki et al. [15] (2012, USA)	prospective	51	no	High-flux HD, BFR: unavailable	–	No data	51%	–	–
Artunc et al. [16] (2012, German)	cross-sectional	239	no	High-flux HD (92%), BFR 300 mL/min	3.8 (IQR 1.6–7.1)	14 (IQR 7–29)	14%	–	–
Cardinaels et al. [18] (2015, Netherlands)	cross-over study	13	no	High-flux HD (at baseline)	4.1 ± 2.4	No data	23%	Not significant	Not performed
Skadberg et al. [19] (2016, Norway)	prospective	20	no	High-flux HD, BFR: unavailable	1.2 (range 0.2–9.6)	13.3 (range 3.9–115.9)	40%	Decrease (−7.6%)	5% (1/20) of patients
The present study (Tarapan et al.)	cross-sectional	100	107 non-CKD	High-flux HD, BFR 358 mL/min	4.5 (1–7)	54.3 (IQR 20.6–152.7)	73%	Decrease (−36%)	25% (25/100) of patients

Assa S, Gansevoort RT, Westerhuis R, et al. Determinants and prognostic significance of an intra-dialysis rise of cardiac troponin I measured by sensitive assay in hemodialysis patients. Clin Res Cardiol. 2013;102:439–445.

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Kumar N, Michelis MF, DeVita MV, et al. Troponin I levels in asymptomatic patients on haemodialysis using a high-sensitivity assay. Nephrol Dial Transplant. 2011;26:665–670.

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Gaiki MR, DeVita MV, Michelis MF, et al. Troponin I as a prognostic marker of cardiac events in asymptomatic hemodialysis patients using a sensitive troponin I assay. Int Urol Nephrol. 2012;44:1841–1845.

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Artunc F, Mueller C, Breidthardt T, et al. Sensitive troponins–which suits better for hemodialysis patients? Associated factors and prediction of mortality. PLoS One. 2012;7:e47610.

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Cardinaels EP, Cornelis T, van der Sande FM, et al. Acute effects of conventional and extended hemodialysis and hemodiafiltration on high-sensitivity cardiac troponins. Clin Chem Lab Med. 2015;53:e289–e292.

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Skadberg O, Sandberg S, Roraas T, et al. The variation in high sensitive cardiac troponin concentration during haemodialysis treatment is not similar to the biological variation observed in stable end stage renal disease patients. Scand J Clin Lab Invest. 2016;76:645–652.

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