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Abstract: SA-PO581

Variability of Troponin I Levels in Patients on Chronic Haemodialysis over One Week

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Durlen, Ivan, Dubrava University Hospital, Zagreb, Croatia
  • Babic, Petar, Dubrava University Hospital, Zagreb, Croatia
  • Bedalov Crnkovic, Ivana, Dubrava University Hospital, Zagreb, Croatia
  • Savuk, Ana, Dubrava University Hospital, Zagreb, Croatia
  • Derek, Lovorka, Dubrava University Hospital, Zagreb, Croatia
  • Horvatic, Ivica, Dubrava University Hospital, Zagreb, Croatia
Background

Patients undergoing chronic haemodialysis (HD) have remarkably higher risk for major adverse cardiovascular events. Haemodynamic and volume changes inbetween dialysis sessions lead to constant cardiac burdain and strain which could increase cardiac troponin levels without signs and symptoms of an acute coronary syndrome (ACS). This makes it more difficult to diagnose acute disorders. Primary goal was to evaluate the basal troponin values of HD patients on their first weekly treatment (the highest volume overload) and observe value oscillations during the week.

Methods

Data of 67 patients (24 female, 43 male) undergoing chronic HD programme at Dubrava University Hospital were collected after aquiring informed consent. Troponin levels were measured multiple times during the period of one week, using Beckman Coulter High-Sensitivity Troponin I (hs-cTnI) assay - before every HD session, after the first session that week and the day after the first session, what resulted with 3 to 5 values per patient depending on the dialysis regiment. Upper reference limit (URI) for hs-cTnI is <14.9 ng/L for female patients and <19.8 ng/L for male patients.

Results

Before the first session, mean basal hs-cTnI was 30,6ng/L (range 5,1 ng/L - 211,2 ng/L), with differences in male (34,6ng/L – 75% higher than URI) and female patients (23,8 ng/L – 60% higher than URI). More male patients had hs-cTnI levels in the reference interval, 51% opposed to 36% of female patients. However, more male patients had values higher than 50 ng/L (6 males, 1 female). The highest mean value was measured after the first dialysis session of the week (32,7 ng/L) and the lowest before the last session in the week (25,8 ng/L). A 7-percent rise in mean value was recorded after one dialysis session. The coefficient of variation (CV) was measured for each patient and the mean CV for hs-cTnI values was 19,6% (2% - 67%) with significant difference between female (13,5%) and male (23%) patients.

Conclusion

Our results show that hs-cTnI values were elevated in 54% of patients on chronic HD without signs of ACS with mean value of 30,1 ng/L out of all the measurements. During one week hs-cTnI values were acceptably stabile with variability of 20%. Patient's hs-cTnI mean value could be taken as a personal basal value for comparison when diagnosing ACS.

Funding

  • Government Support – Non-U.S.