Cardiac biomarkers and noninvasive predictors of atherosclerosis in chronic peritoneal dialysis patients

Kidney Blood Press Res. 2012;35(5):340-8. doi: 10.1159/000332084. Epub 2012 Apr 3.

Abstract

Background: We investigated the relationship among serum cardiac biomarkers including N-terminal pro-brain natriuretic peptide (NT-pro-BNP), cardiac troponin T (cTnT), uric acid and high-sensitive C-reactive protein (hs-CRP) and noninvasive predictors of atherosclerosis including carotid intima-media thickness (IMT), aortic stiffness (pulse wave velocity (PWV)) and transthoracic coronary flow reserve (CFR) in peritoneal dialysis (PD) patients.

Methods: 37 PD patients were included in the study. We measured (1) carotid IMT, (2) PWV and augmentation index (AIx), and (3) CFR. Simultaneous measurements of serum NT-pro-BNP, cTnT, uric acid and hs-CRP were also performed. Associations among these variables were analyzed.

Results: cTnT was significantly associated with carotid IMT (r = 0.747, p < 0.001), PWV (r = 0.431, p = 0.035) and CFR (r = -0.439, p = 0.007). In multivariate analysis, cTnT was a significant independent predictor of carotid IMT (β = 4.446, p < 0.001) and CFR (β = -2.272, p = 0.013). Patients with high cTnT levels (≥0.01 ng/ml) significantly hadhigher carotid IMT and PWV values. Only the aortic PWV significantly correlated with residual renal function (r = -0.574, p = 0.004).

Conclusions: Serum cTnT appeared to be a useful clinical biomarker for evaluating noninvasive predictors of atherosclerosis in chronic PD patients. Arterial stiffness as determined by PWV is also correlated with residual renal function.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atherosclerosis / blood*
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / physiopathology
  • Biomarkers / blood
  • Blood Flow Velocity
  • C-Reactive Protein / metabolism
  • Carotid Intima-Media Thickness
  • Child
  • Child, Preschool
  • Coronary Circulation
  • Female
  • Humans
  • Infant
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Peritoneal Dialysis*
  • Predictive Value of Tests
  • Pulsatile Flow
  • Troponin T / blood
  • Uric Acid / blood
  • Vascular Stiffness
  • Young Adult

Substances

  • Biomarkers
  • Peptide Fragments
  • Troponin T
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Uric Acid
  • C-Reactive Protein