Effect of Hemodialysis, Coronary Artery Disease and Diabetes on Cardiac Troponin T: A Prospective Survey Over One Year

BACKGROUND: Limited data is available about the effects of hemodialysis sessions, coronary artery disease (CAD), and diabetes on serum cardiac troponin T (cTnT) levels in patients with end-stage renal disease (ESRD). OBJECTIVES: To test whether hemodialysis could be associated with an increase in cTnT concentration. To evaluate if coronary artery disease (CAD) or diabetes are associated with higher cTnT levels in ESRD. METHODS: Serum cTnT levels were measured immediately before and after dialysis 3 times over 1 year (0, 6, and 12 months). RESULTS: A total of 100 ESRD patients without acute coronary syndrome (mean age of 58.5 years, 34% with diabetes, and 37% with CAD) gave 267 pre-dialysis and 260 post-dialysis blood samples. The mean (standard deviation) pre-dialysis cTnT levels were 0.06 (0.12), 0.05 (0.06), and 0.07 (0.07) mcg/L at 0, 6, and 12 months, respectively. The post-dialysis cTnT levels were similar on average. Among 259 samples with cTnT measured both before and after dialysis, 79 (30.5%) showed a decrease in serum cTnT, 97 (37.5%) showed an increase and 83 (32%) showed no change following dialysis. Mean cTnT was higher in CAD than in non-CAD patients. We observed no significant difference in mean cTnT levels between diabetic and non-diabetic patients. CONCLUSIONS: cTnT levels were not affected by individual hemodialysis sessions, and remained stable around 0.06 mcg/L over a 1-year period in ESRD patients. Random cTnT levels were higher in stable CAD patients undergoing hemodialysis.