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Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients

PURPOSE: We examined the association between extracorporeal dialysis (ED)-related effective blood flow (eQB) and serum cardiac troponin T (cTnT) as a possible indicator of silent myocardial damage in stable ED patients. METHODS: In a cross-sectional study, cTnT was determined in 247 ED patients dial...

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Autores principales: Grzegorzewska, Alicja E., Cieszyński, Krzysztof, Niepolski, Leszek, Kaczmarek, Andrzej, Sowińska, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769722/
https://www.ncbi.nlm.nih.gov/pubmed/26603871
http://dx.doi.org/10.1007/s11255-015-1165-z
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author Grzegorzewska, Alicja E.
Cieszyński, Krzysztof
Niepolski, Leszek
Kaczmarek, Andrzej
Sowińska, Anna
author_facet Grzegorzewska, Alicja E.
Cieszyński, Krzysztof
Niepolski, Leszek
Kaczmarek, Andrzej
Sowińska, Anna
author_sort Grzegorzewska, Alicja E.
collection PubMed
description PURPOSE: We examined the association between extracorporeal dialysis (ED)-related effective blood flow (eQB) and serum cardiac troponin T (cTnT) as a possible indicator of silent myocardial damage in stable ED patients. METHODS: In a cross-sectional study, cTnT was determined in 247 ED patients dialyzed using stable eQB and dialysate flow (QD). In a prospective study, 91 patients were switched from low-flux (LF) to high-flux (HF) hemodialysis (HD), and subsequently, the eQB increased, and the QD decreased; 65 patients continued LF-HD with stable eQB and QD. Clinical/laboratory evaluations were performed at 0, 15, 36, and 53 weeks from the start of the study. RESULTS: In the cross-sectional study, the main cTnT predictors were dialysis vintage, age, eQB, phosphorus, and C-reactive protein. Patients with cTnT levels in the highest quartile were excluded from the analysis, and subjects dialyzed with eQB ≤316 ml/min exhibited lower cTnT levels compared with patients dialyzed with higher eQB (P = 0.002). The all-cause and cardiac mortality rates of 154 patients, without changes in ED modality for up to 42 months, were associated with the initial cTnT concentrations but not with the initial eQB. In the prospective study, higher values for eQB and cTnT were observed during HF-HD at weeks 36 (P = 0.045) and 53 (P = 0.01) of the present study. The initial cTnT, ∆eQB, and ∆albumin influenced the ∆cTnT. The all-cause and cardiac mortality rates were not different between LF and HF groups at 21 months after the prospective study was completed. CONCLUSION: In stable ED patients, higher eQB rates and QB/QD values might contribute to silent myocardial injury, particularly in patients with lower cTnT levels, but do not affect the outcome of ED patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11255-015-1165-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-47697222016-03-29 Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients Grzegorzewska, Alicja E. Cieszyński, Krzysztof Niepolski, Leszek Kaczmarek, Andrzej Sowińska, Anna Int Urol Nephrol Nephrology - Original Paper PURPOSE: We examined the association between extracorporeal dialysis (ED)-related effective blood flow (eQB) and serum cardiac troponin T (cTnT) as a possible indicator of silent myocardial damage in stable ED patients. METHODS: In a cross-sectional study, cTnT was determined in 247 ED patients dialyzed using stable eQB and dialysate flow (QD). In a prospective study, 91 patients were switched from low-flux (LF) to high-flux (HF) hemodialysis (HD), and subsequently, the eQB increased, and the QD decreased; 65 patients continued LF-HD with stable eQB and QD. Clinical/laboratory evaluations were performed at 0, 15, 36, and 53 weeks from the start of the study. RESULTS: In the cross-sectional study, the main cTnT predictors were dialysis vintage, age, eQB, phosphorus, and C-reactive protein. Patients with cTnT levels in the highest quartile were excluded from the analysis, and subjects dialyzed with eQB ≤316 ml/min exhibited lower cTnT levels compared with patients dialyzed with higher eQB (P = 0.002). The all-cause and cardiac mortality rates of 154 patients, without changes in ED modality for up to 42 months, were associated with the initial cTnT concentrations but not with the initial eQB. In the prospective study, higher values for eQB and cTnT were observed during HF-HD at weeks 36 (P = 0.045) and 53 (P = 0.01) of the present study. The initial cTnT, ∆eQB, and ∆albumin influenced the ∆cTnT. The all-cause and cardiac mortality rates were not different between LF and HF groups at 21 months after the prospective study was completed. CONCLUSION: In stable ED patients, higher eQB rates and QB/QD values might contribute to silent myocardial injury, particularly in patients with lower cTnT levels, but do not affect the outcome of ED patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11255-015-1165-z) contains supplementary material, which is available to authorized users. Springer Netherlands 2015-11-24 2016 /pmc/articles/PMC4769722/ /pubmed/26603871 http://dx.doi.org/10.1007/s11255-015-1165-z Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Nephrology - Original Paper
Grzegorzewska, Alicja E.
Cieszyński, Krzysztof
Niepolski, Leszek
Kaczmarek, Andrzej
Sowińska, Anna
Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title_full Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title_fullStr Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title_full_unstemmed Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title_short Serum cardiac troponin T and effective blood flow in stable extracorporeal dialysis patients
title_sort serum cardiac troponin t and effective blood flow in stable extracorporeal dialysis patients
topic Nephrology - Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769722/
https://www.ncbi.nlm.nih.gov/pubmed/26603871
http://dx.doi.org/10.1007/s11255-015-1165-z
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