Kidney Disease

High Troponin Levels In CKD Increase Mortality Risk 4 Fold

Higher levels of troponin in patients chronic kidney disease (CKD) that are receiving dialysis yielded a 2–to-4-fold increased risk in all-cause mortality and adverse cardiovascular events, including death, according to a recent study.

In order to better understand the diagnostic value of troponin testing in patients with CKD and acute coronary syndrome (ACS), researchers evaluated 98 studies that compared elevated troponin levels to normal troponin levels in CKD patients without suspected ACS.
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Overall, the all–cause mortality hazard ratio for troponin T (HR: 3.0) was greater than that of troponin I (HR: 2.7).  However, the hazard ratios for cardiovascular mortality in troponin T (HR: 3.3) were less than in troponin I (HR: 4.2).

Researchers found similar results in CKD patients who did not receive dialysis (a higher risk of all-cause mortality and cardiovascular death), but they noted that results are a reflection of fewer studies.

Researchers cautioned that the measurement of troponin levels could lead to false-positive results in CKD patients.

The complete study is published in the August issue of Annals of Internal Medicine.

-Michelle Canales

References:

Michos ED, Wilson LM, Yeh HC, et al. Prognostic value of cardiac troponin in patients with chronic kidney disease without suspected acute coronary syndrome: a systematic review. Ann Intern Med. 2014 August [epub ahead of print] doi: 10.7326/M14-0743.

Kussmaul  III WG, Sehgal AR. Claring Up Cardiorenal Confusion. Ann Intern Med. 2014 August [epub ahead of print] doi: 10.7326/M14-1630.