C-terminal Propeptide of Type-I Procollagen as a Possible Biochemical Marker for Preclinical Detection of Cardiac Disease in Chronic Renal Failure

The aim of present research was to investigate the possible role of C-terminal propeptide of type-I procollagenas a biochemical marker for early preclinical detection of Left Ventricular (LV) dysfunction in children with CRF. The study included 25 children with CRF undergoing hemodialysis for at least six months. Their age ranged from 8-16 years. Patients were receiving erythropoietin and anti-hypertensive medications. Serum was withdrawn from patients during the time interval between two dialytic sessions for estimation of CICP. The systolic and diastolic functions of the LV were investigated by echocardiography. Mean level of CICP was significantly higher in patients than in controls. Echocardiographic findings revealed significantly higher mean LV mass index, interventricular septal thickness, LV posterior wall thickness and E/A ratio in patients versus controls. Left atrial and ventricular diameters were significantly higher, whereas EF and FS% were lower in patients than controls. There were positive correlations between CICP levels and LVMI, IVST, LVPWT and E/A ratio. CICP correlated with the duration of illness, blood pressure, BUN and creatinine. We conclude that CICP levels are strongly correlated with the early changes that occur in the heart of CRF children, namely LV hypertrophy and diastolic filling abnormalities. CICP could be used as a reliable preclinical serological marker for detection of these changes.