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Vol 21, No 4 (2017)
ORIGINAL PAPERS
Published online: 2017-10-20
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Effect of hydration status and variability of blood pressure and heart rate induced by hemodialysis on intradialytic changes of high sensitive troponin T

Małgorzata Jadwiga Wajdlich, Paulina Podlejska, Dominika Rosół, Marta Wynimko, Monika Kolejwa, Mateusz Sajdok, Marek Maciejewski, Michał Nowicki
DOI: 10.5603/AH.a2017.0023
·
Arterial Hypertension 2017;21(4):186-194.

open access

Vol 21, No 4 (2017)
ORIGINAL PAPERS
Published online: 2017-10-20

Abstract

Introduction. High sensitivity troponin T (TnT-hs) is biomarker of myocardial damage and ischemia. Despite its elevation troponin still preserve its usefulness as a marker of the cardiovascular risk and mortality in chronic kidney disease. Variations of hydration status between and during hemodialysis exert significant hemodynamic effects, which may negatively affect cardiovascular system and blood pressure and lead to myocardial damage. The aim of the study was to access the effect of hydration status and variability of blood pressure and heart rate induced by hemodialysis on intradialytic changes of TnT-hs, in chronic hemodialysis patients. Material and methods. In 50 chronic hemodialysis patients (35M, 15F, mean age 64 ± 12 years) blood pressure and heart rate were monitored noninvasively during HD session. Serum concentration of TnT-hs and hydration status were assessed before and after hemodialysis. Results. TnT-hs concentration was above normal range in 98% patients before, and in all after hemodialysis. Median TnT-hs level was 82 ng/L before and 84 ng/L after hemodialysis, which comprised 586% and 600% of the upper limit of normal range. There was a small 2.4%, intradialytic increase of TnT-hs (p = 0.004). TnT-hs levels correlated positively with mean interdialytic weigh gain, before HD (r = 0.43, p = 0.02) and after HD (r = 0.5, p = 0.003). There was also a positive correlation between TnT-hs concentration and mean heart rate (r = 0.37, p = 0.008) and with mean systolic blood pressure during HD, before HD (r = 0.3, p = 0.026) and after HD (r = 0.3, p = 0.031). Conclusions. Hemodialysis can be a risk factor of myocardial injury, especially in overhydrated patients.

Abstract

Introduction. High sensitivity troponin T (TnT-hs) is biomarker of myocardial damage and ischemia. Despite its elevation troponin still preserve its usefulness as a marker of the cardiovascular risk and mortality in chronic kidney disease. Variations of hydration status between and during hemodialysis exert significant hemodynamic effects, which may negatively affect cardiovascular system and blood pressure and lead to myocardial damage. The aim of the study was to access the effect of hydration status and variability of blood pressure and heart rate induced by hemodialysis on intradialytic changes of TnT-hs, in chronic hemodialysis patients. Material and methods. In 50 chronic hemodialysis patients (35M, 15F, mean age 64 ± 12 years) blood pressure and heart rate were monitored noninvasively during HD session. Serum concentration of TnT-hs and hydration status were assessed before and after hemodialysis. Results. TnT-hs concentration was above normal range in 98% patients before, and in all after hemodialysis. Median TnT-hs level was 82 ng/L before and 84 ng/L after hemodialysis, which comprised 586% and 600% of the upper limit of normal range. There was a small 2.4%, intradialytic increase of TnT-hs (p = 0.004). TnT-hs levels correlated positively with mean interdialytic weigh gain, before HD (r = 0.43, p = 0.02) and after HD (r = 0.5, p = 0.003). There was also a positive correlation between TnT-hs concentration and mean heart rate (r = 0.37, p = 0.008) and with mean systolic blood pressure during HD, before HD (r = 0.3, p = 0.026) and after HD (r = 0.3, p = 0.031). Conclusions. Hemodialysis can be a risk factor of myocardial injury, especially in overhydrated patients.
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Keywords

hemodialysis, overhydration, troponin T, TnT-hs

About this article
Title

Effect of hydration status and variability of blood pressure and heart rate induced by hemodialysis on intradialytic changes of high sensitive troponin T

Journal

Arterial Hypertension

Issue

Vol 21, No 4 (2017)

Pages

186-194

Published online

2017-10-20

DOI

10.5603/AH.a2017.0023

Bibliographic record

Arterial Hypertension 2017;21(4):186-194.

Keywords

hemodialysis
overhydration
troponin T
TnT-hs

Authors

Małgorzata Jadwiga Wajdlich
Paulina Podlejska
Dominika Rosół
Marta Wynimko
Monika Kolejwa
Mateusz Sajdok
Marek Maciejewski
Michał Nowicki

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