Circulating N-Terminal Pro-Brain Natriuretic Peptide and
Cardiac Troponin T in Chronic Dialysis Patients
WATTANA LEOWATTANA, MD*, LEENA ONG-AJYOOTH, MD**,
PUNT APONG T ARUANGSRI, MD**, SASIKANT POKUM, BSc*
Affiliation : * Department of Clinical Pathology,
** Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractIn the general population, plasma concentrations of cardiac troponin T (cTnT) and N-termi
nal pro-brain natriuretic peptides (NT-proBNP) are useful as markers of cardiac ischemia and heart
failure respectively. Whether these cardiac markers have similar diagnostic potential in chronic dialy
sis patients are not known. The authors studied the diagnostic value of cTnT and NT-proBNP correlated
with the clinical status of 63 chronic renal failure (CRF) patients with chronic dialysis (30 males and
33 females), aged 26 to 77 years (mean± SD, 55.9 ± 12.6 years). Plasma cTnT and NT-proBNP were
determined by using Elecsys 2010 (Roche, Switzerland). The authors found that 23.8 per cent of the
chronic dialysis patients had cTnT concentrations more than the cut-off(::?. 0.1 ng/ml) and 100 per cent
of these patients had NT-proBNP concentrations over the cut-off(> 334 pg/ml). The authors could
not demonstrate the statistical difference between males and females for NT-proBNP concentrations
as reported in the general population. But cTnT concentrations in females were significantly less than
males. The authors also found a weak correlation between the two markers, when the circulating cTnT
was correlated with NT-proBNP. These results suggested that plasma cTnT in chronic dialysis patients
should be a prognostic marker for cardiac ischemia by using the same cut-off as the normal popula
tion. However, plasma NT-proBNP concentrations could not be used as a heart failure marker in this
group of patients and needed another cut-off value for specific use in chronic dialysis patients. More
over, the combination of cTnT and NT-proBNP concentrations in these patients may be another choice
for detection of both cardiac ischemia and heart failure in the same situation. These combination
markers should improve mortality in chronic dialysis patients.
Keywords : Chronic Dialysis, Chronic Renal Failure, NT-proBNP, cTnT
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