High-sensitive troponin T, suPAR and Beta-2-microglobulin changes in concentration during hemodialysis.

IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Scandinavian Journal of Clinical & Laboratory Investigation Pub Date : 2024-09-01 Epub Date: 2024-08-24 DOI:10.1080/00365513.2024.2394794
Jan D Kampmann, Michael M Hunderup, Eva R Brix Petersen, Vivi Andersen, Thor A Skovsted
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Abstract

Hemodialysis (HD) patients are at high risk of cardiovascular disease and death. Reliable biomarkers for risk stratification and detection of acute myocardial infarction (AMI) are therefore pivotal. Cardiac troponins (cTn) are the preferred biomarkers for AMI. It remains unclear, if cTn concentrations changes as a consequence of HD treatment itself during dialysis. In this study, cTn was compared with soluble urokinase plasminogen activator receptor (suPAR) and Beta-2-microglobulin (B2M). We performed a prospective study including 17 HD patients measuring high-sensitive cardiac troponin t (hs-cTnT), suPAR and B2M before and after a dialysis session and verified the results in a random subgroup of eight patients from the group by repeating their measurements before and after a dialysis session 15 weeks later. Biomarker concentrations after dialysis were adjusted according to hemodilution or concentration according to the hemoglobin concentration. The average hs-cTnT concentration decreased significantly by -9.9% after dialysis (95% CI: -13.6% to -6.2%). The average (paired) difference were - 6.7 ng/L (p = 0.0104) after dialysis comparing 25 HD treatment occasions. SuPAR was not significantly influenced by dialysis. B2M decreased by -58% after HD as an expected result from the molecular size of the biomarker. The hs-cTnT in average decreased by -9.9% after dialysis. This is a diagnostic challenge since the current guidelines suggest a 20% change in hs-cTnT in patients with acute myocardial infarction. Larger prospective studies investigating the different factors influencing hs-cTnT after HD are warranted. Adjusting biomarker concentrations according to hemodilution or concentration using the hemoglobin concentration, should be considered in future studies to determine more exact changes in concentrations of cTnT and other relevant biomarkers.

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血液透析期间高敏肌钙蛋白 T、suPAR 和 Beta-2 微球蛋白浓度的变化。
血液透析(HD)患者罹患心血管疾病和死亡的风险很高。因此,用于风险分层和检测急性心肌梗死(AMI)的可靠生物标志物至关重要。心肌肌钙蛋白(cTn)是急性心肌梗死的首选生物标志物。目前还不清楚透析过程中的 cTn 浓度是否会因血液透析治疗本身而发生变化。本研究将肌钙蛋白与可溶性尿激酶纤溶酶原激活物受体(suPAR)和β-2-微球蛋白(B2M)进行了比较。我们对 17 名血液透析患者进行了一项前瞻性研究,在透析前后测量了高敏心肌肌钙蛋白 t(hs-cTnT)、suPAR 和 B2M,并在 15 周后的透析前后对随机分组的 8 名患者进行了重复测量,以验证结果。透析后的生物标志物浓度根据血液稀释或血红蛋白浓度进行调整。透析后,hs-cTnT 平均浓度显著下降了 -9.9%(95% CI:-13.6% 至 -6.2%)。与 25 次血液透析治疗相比,透析后的平均(配对)差异为 - 6.7 纳克/升(p = 0.0104)。透析对 SuPAR 没有明显影响。血液透析后,B2M 下降了 -58%,这是生物标志物分子大小的预期结果。透析后,hs-cTnT平均下降了-9.9%。这是一项诊断挑战,因为现行指南建议急性心肌梗死患者的 hs-cTnT 变化幅度为 20%。有必要进行更大规模的前瞻性研究,调查影响血液透析后 hs-cTnT 的不同因素。今后的研究应考虑根据血液稀释或血红蛋白浓度调整生物标志物浓度,以确定 cTnT 和其他相关生物标志物浓度的更准确变化。
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来源期刊
CiteScore
3.50
自引率
4.80%
发文量
85
审稿时长
4-8 weeks
期刊介绍: The Scandinavian Journal of Clinical and Laboratory Investigation is an international scientific journal covering clinically oriented biochemical and physiological research. Since the launch of the journal in 1949, it has been a forum for international laboratory medicine, closely related to, and edited by, The Scandinavian Society for Clinical Chemistry. The journal contains peer-reviewed articles, editorials, invited reviews, and short technical notes, as well as several supplements each year. Supplements consist of monographs, and symposium and congress reports covering subjects within clinical chemistry and clinical physiology.
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