Hemodiyaliz öncesinde ve sonrasında kardiyak troponin-I ve miyoglobin seviyelerinin incelenmesi

Amaç: Son dönem böbrek hastalarında serum troponin I düzeyi kardiyak iskemi olmaksızın yükselebilir. Bunun nedeni açık değildir. Bu çalışmada, kronik hemodiyaliz programına giren 52 hastada diyaliz öncesi ve sonrasında serum troponin-I (cTnI) düzeylerinde yükselme olup olmadığının araştırılması amaçlandı. Yöntemler: cTnI ve miyoglobin düzeyleri kemilüminisans metodu ile serumda çalışıldı. Total kreatin kinaz (CPK) ve CK-MB aktivitesi rutin kolorimetrik ve immunometrik metodla çalışıldı. Tüm hastalar klinik özgeçmişlerine göre iki gruba ayrıldı. Birinci grup koroner risk faktörlerinden sadece birine, ikinci grup ise iki veya daha fazla major risk faktörüne sahipti. cTnI, CPK, CK-MB ve miyoglobin düzeylerinin diyaliz öncesi ve sonrası değerleri arasındaki fark non-parametrik Wilcoxon signed rank testi ile karşılaştırıldı. Bulgular: Hemodiyaliz sonrasında öncesine göre CK-MB, CPK, miyoglobin ve cTnI değerlerinde önemli fark bulundu. Sonuç: Sonuçlarımıza göre cTnI düzeyleri hemodiyalizden etkilenmemektedir.

The investigation of cardiac troponin-I and myoglobin levels before and after renal dialysis

Objective: In patients with end-stage renal disease (ESRD), the serum concentration of troponin-I (cTnI) may be increased without cardiac ischemia. The cause of this increase is not clear. In this study, we aimed to investigate whether serum cTnI concentration is increased in 52 patients on chronic maintenance hemodialysis before and after hemodialysis. Methods: cTnI and myoglobin were measured in the sera of patients using chemiluminescent immunoassay. Total creatine kinase (CPK) and CK-MB activity was measured using colorimetric assay and immunometric assay, respectively. All patients of ESRD were divided into two groups according to clinical history: First group; patients with one or no coronary risk factor but ESRD, second group; two or more recognized major risk factors for coronary artery disease in addition to ESRD (such as smoking, hypertension, ischemia, diabetes, congestive heart failure, vascular disease, cardiac arrhythmias). The statistical differences of pre/post hemodialysis between the cTnI, CPK, CK-MB, miyoglobin concentrations in the groups were analyzed by non-parametric Wilcoxon signed rank test. Results: There were significant differences in the pre- and post hemodialysis values of CK-MB, CPK, myoglobin, and cTnI. Conclusion: Regarding to our results, it may be postulated that cTnI is not effected from hemodialysis.

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