High sensitive troponin concentration stability in dialysate of anuric patients on hemodialysis

Sa？etak Background. High sensitive troponin I (hsTnI) and high sensitive troponin T (hsTnT) are markers of cardiac damage. Cardiomyocyte necrosis increases its blood levels. It is known that dialysis is cardiotoxic and that results in lack of contractility of certain myocardial segments. Tis mechanism is primarily due to hypo perfusion of the myocardium during dialysis. Te dialysis itself increases cardiovascular (CV) risk in patients by many different mechanisms. It has been proven that the incidence of heart failure is much more frequent in patients on hemodialysis than in healthy population. Te aim of this pilot study was to investigate the presence of troponin T molecules and troponin I in dialysate and compare their concentrations. Materials and Methods. Te study included 5 anuric patients (4M) on hemodialysis. Te dialysate samples were sampled for each patient three times during a dialysis cycle. Te frst sample was taken afer thirty minutes, the second sample was taken in the middle of dialysis (120 minutes) and the third sample was taken thirty minutes before the end of dialysis. Te value of hsTnI was measured using a high-sensitivity test on the Immuno-enzymatic analyzer Abbott Architest i1000SR. According to CLSI EP15-A2 protocol verifcation of hsTnT chemiluminescent micro-particle immunoassay on the analytical platform Roche cobas e411 was performed. Results. Altogether 15 samples (three for each patient) were processed. hsTnT was detected in all 15 samples (13.42 ± 1.18 ng / L), while hsTnI was detected in only 8 samples (0.14 ± 0.16 ng / L). To test the difference in detectability between hsTnT and hsTnI, chi square test was used and the difference was statistically signifcant (Yates chi-square 6.708, p = 0.009). Conclusion. Te presence of troponin molecules in dialysate was determined for the frst time in scientifc literature. Tis study has confrmed that TnT is present in all dialysate samples and that its concentration is stable in dialysate. TnI concentrations were detectable in signifcantly lower concentrations