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NDT Advance Access originally published online on September 26, 2007
Nephrology Dialysis Transplantation 2008 23(1):231-238; doi:10.1093/ndt/gfm513
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


Impact of kidney function on plasma troponin concentrations after coronary artery bypass grafting

Regine Wießner1,*, Kurt Hannemann-Pohl2, Reinhard Ziebig1,*, Herko Grubitzsch3, Berthold Hocher4, Ortrud Vargas-Hein5, Andreas Lun1, Ingolf Schimke6 and Lutz Liefeldt7

1Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Zentralinstitut für Laboratoriumsmedizin und Pathobiochemie, Charité-Platz 1, 10117 Berlin, 2Marienkrankenhaus gGmbH, Akademisches Lehrkrankenhaus der Universität Hamburg, Institut für Laboratoriumsmedizin, Mikrobiologie und Transfusionsmedizin, Alfredstraße 9, 22087 Hamburg, 3Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Klinik für Kardiovaskuläre Chirurgie, 4Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Institut für Pharmakologie, Center for Cardiovascular Research (CCR), 5Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Klinik für Anästhesiologie und operative Intensivmedizin, 6Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Medizinische Klinik mit Schwerpunkt Kardiologie, Pulmologie, Angiologie and 7Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Medizinische Klinik mit Schwerpunkt Nephrologie, Berlin, Germany

Correspondence to: Reinhard Ziebig, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Zentralinstitut für Laboratoriumsmedizin und Pathobiochemie, Charité-Platz 1, 10117 Berlin, Germany. Email: reinhard.ziebig{at}charite.de



  Abstract

Background. To date, there have been no studies reliably showing an influence of the kidney on the concentration of troponins. We therefore analysed the concentration curves in patients after coronary artery bypass grafting (CABG) according to their dependence on renal function.

Methods. We determined cardiac troponin I (cTnI), cardiac troponin T (cTnT) and creatinine in plasma in 28 patients after CABG. Discrimination into patients with normal (n = 13) and impaired (n = 15) renal function was based on creatinine clearance (Crea-Clear). The curves for cTnI and cTnT, as recorded by post-operative measurements, were approximated using mathematical functions. The curve parameters peak maximum (Pmax), peak position (Ppos), half-height breadth (HHB) and area under the curve (AUC) were established after this. Assuming an exponential function, the half-life (t1/2) of cTnI was determined from the declining part of the curve.

Results. For both, cTnI and cTnT, significant differences in Pmax, Ppos, HHB and AUC were detected after curve approximation. The t1/2 values of cTnI were 25.1 h (22.0–35.3) for the group with normal renal function and 38.4 h (35.9–51.9) for patients with impaired renal function (P = 0.001). An influence of diabetes mellitus (Dm), renal replacement therapy or the age of the patients could not be verified.

Conclusion. The results of this study clearly demonstrate that kidney function has an impact on plasma troponin concentrations. In everyday clinical practice this has to be considered when interpreting elevated plasma troponin concentration in patients with impaired renal function.

Keywords: coronary artery bypass grafting; curve approximation; half-life; troponin I; troponin T; renal function

*These two authors have contributed equally to this work.

Received for publication: 26. 4.06
Accepted in revised form: 4. 7.07


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