RESUMEN
OBJECTIVES: The aim of the study was investigate the prevalence of abnormal values of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in patients with chronic renal failure (CRF) and their clinical significance. DESIGN AND METHODS: We investigated the concentrations of cTnT and cTnI in 49 CRF patients without heart disease or diabetes. Cardiac TnT values were measured with a second generation immunoassay and cTnI with two immunoassays with different analytical sensitivity. All CRF patients underwent regular clinical follow-up over a 18-month period. RESULTS: No patients with CRF had elevated values of cTnI when measured with one assay and only 2 patients displayed minimally elevated values with the second assay. In contrast, 23 CRF patients (47%) displayed cTnT concentrations elevated above the upper reference limit. The elevated cTnT values observed were below the values detected in acute myocardial infarction and were not associated with adverse cardiac events during follow-up. CONCLUSIONS: Mildly elevated cTnT concentrations are common in patients with CRF and do not appear to be associated with adverse coronary events.
Asunto(s)
Fallo Renal Crónico/metabolismo , Fallo Renal Crónico/terapia , Miocardio/metabolismo , Troponina I/sangre , Troponina T/sangre , Adulto , Anciano , Biomarcadores/sangre , Creatina Quinasa/sangre , Femenino , Humanos , Inmunoensayo/métodos , Trasplante de Riñón , Masculino , Persona de Mediana Edad , Mioglobina/análisis , Valor Predictivo de las Pruebas , Terapia de Reemplazo Renal , Sensibilidad y EspecificidadRESUMEN
The comparison of total body water obtained by Watson formula with results of bioelectrical impedance (BIA) shows a fair approximation (Delta% = 1.0 +/- 8.45). However, when compared to other literature formulas the BIA values are higher (8 divided by 23%), and this discrepancy needs further analysis. Urea kinetics was computed using as input data for distribution volume both the Watson anthropometrical and the BIA TBW values: the clearance results do not differ significantly (Delta% = 0.74 +/- 8.35). The Kt/V index results are nearly identical (Delta% = 0.12 +/- 1.17), due to a mathematical loop: a wrong input of volume induces a comparable error of the clearance result, while their ratio is unchanged. For practical routine to monitoring dialysis adequacy the Watson anthropometrical formula has proven as a satisfactory simple approach. Periodical BIA determination provides useful informations mainly when the anthropometrical estimation are doubtful and the comparison of data may increase the kinetic reliability.