Department of Chemical Pathology, Labplus, Auckland City Hospital, Auckland, New Zealand.
Ren Fail. 2012;34(1):35-9. doi: 10.3109/0886022X.2011.623440. Epub 2011 Oct 20.
To investigate and describe cardiac troponins in subjects with acute kidney injury (AKI).
A prospective observational study of troponin in subjects presenting with AKI in a tertiary hospital. Creatine kinase-MB (CKMB), troponin I (Abbott Laboratories), and troponin T (Roche 4th generation) were measured. Patients with conditions known to cause elevated troponin levels were excluded.
Nineteen subjects were enrolled in the study. Six subjects had troponin I and T concentrations above the 99th percentile of a reference population. There was high concordance of result between troponin I and troponin T. However, the concordance of elevated troponin levels with CKMB was less marked at 45%. Statistically significant factors associated with elevated troponin levels were age over 60 years, abnormal electrocardiogram, and history of previous ischemic heart disease.
This is the first study able to demonstrate impaired renal function occurring acutely, without known confounders, results in elevated troponin levels. This suggests that impaired renal function disease influences plasma troponin levels in AKI as well as in chronic kidney failure.
研究并描述急性肾损伤(AKI)患者中的心肌肌钙蛋白。
对一家三级医院中出现 AKI 的患者进行了肌钙蛋白的前瞻性观察性研究。测定肌酸激酶同工酶-MB(CKMB)、肌钙蛋白 I(雅培实验室)和肌钙蛋白 T(罗氏第 4 代)。排除已知会引起肌钙蛋白水平升高的疾病。
本研究共纳入 19 名患者。6 名患者的肌钙蛋白 I 和 T 浓度高于参考人群第 99 百分位数。肌钙蛋白 I 和肌钙蛋白 T 的检测结果具有高度一致性。然而,肌钙蛋白升高与 CKMB 的一致性较低,为 45%。与肌钙蛋白升高相关的统计学显著因素是年龄超过 60 岁、心电图异常和既往缺血性心脏病史。
这是第一项能够证明急性肾功能不全而无已知混杂因素时会导致肌钙蛋白水平升高的研究。这表明肾功能不全疾病会影响 AKI 以及慢性肾衰竭患者的血浆肌钙蛋白水平。