Bagheri Nazila, Taziki Omolbanin, Falaknazi Kianoosh
Taleghani Medical Center (Nephrology and Transplantation Ward), Shahid Beheshti Medical University, Tehran, Iran.
Saudi J Kidney Dis Transpl. 2009 Sep;20(5):789-93.
Overall and cardiovascular mortality are significantly higher in hemodialysis patients with elevated C-reactive protein (CRP). The aim of study was to determine whether CRP, low albumin and troponin are markers of overall and cardiovascular mortality in hemodialysis patients. 138 stable hemodialysis patients were divided into 2 groups n= 66 patients with coronary disease equivalent (known coronary or peripheral vascular disease or diabetes mellitus) and n= 72 patients without it. The two groups were then stratified by biomarkers [cardiac troponin T and albumin and highly sensitive CRP (hs-CRP)] and followed for 30 months. The primary outcome was all causes mortality. Patients with coronary disease equivalents had 3.5 fold greater annual mortality compared to controls (24%% vs 6.9%, P value = 0.005). Elevated troponin T had a further increase in the risk for death while hs-CRP and low albumin were not associated with risk of death In conclusion, circulating cardiac troponin-T was associated with poor prognosis especially in hemodialysis patients with coronary risk factors.
C反应蛋白（CRP）升高的血液透析患者的全因死亡率和心血管死亡率显著更高。本研究的目的是确定CRP、低白蛋白和肌钙蛋白是否为血液透析患者全因死亡率和心血管死亡率的标志物。138例稳定的血液透析患者被分为两组，n = 66例患有冠心病等效症（已知冠心病或外周血管疾病或糖尿病）的患者和n = 72例无冠心病等效症的患者。然后根据生物标志物[心肌肌钙蛋白T、白蛋白和高敏CRP（hs-CRP）]对两组进行分层，并随访30个月。主要结局是全因死亡率。患有冠心病等效症的患者的年死亡率是对照组的3.5倍（24%对6.9%，P值=0.005）。肌钙蛋白T升高使死亡风险进一步增加，而hs-CRP和低白蛋白与死亡风险无关。总之，循环心肌肌钙蛋白-T与预后不良相关，尤其是在有冠心病危险因素的血液透析患者中。
