Scandinavian journal of clinical and laboratory investigation · 2016
The variation in high sensitive cardiac troponin concentration during haemodialysis treatment is not similar to the biological variation observed in stable end stage renal disease patients.
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Skadberg Øyvind, Sandberg Sverre, Røraas Thomas, Petersen Per Hyltoft, Sellevoll Hilde, Svarstad Einar, Sæle Kristin, Aakre Kristin Moberg
Аннотация
BACKGROUND: Cardiovascular mortality is high in end stage renal disease (ESRD). This study aimed to: (1) calculate within-week within- and between-subject biological variation (CVI and CVG) for hs-cTn in ESRD; (2) determine the magnitude of hs-cTn concentration changes during haemodialysis (HD) treatment; and (3) compare the CVI and CVG to the within and between-subject variation of cTn concentration changes during HD treatments (CVDIFF-I and CVDIFF-G).
METHODS: Serum samples were collected from 20 patients before and after 10 consecutive HD treatments. cTn were measured using the hs-cTnT (Roche Diagnostics) and the hs-cTnI (Abbott Diagnostics). The CVA, CVI, CVG, CVDIFF-I and CVDIFF-G, were estimated using nested ANOVA.
RESULTS: The within-week data showed hs-cTnT CVA, CVI and CVG of 1.6, 7.3 and 94.4%. Reference change values (RCV) were estimated to -18.7-23.0%. The Index of individuality (II) was 0.08. Corresponding values for hs-cTnI were 5.3, 13.2 and 142.4%, whilst the RCV was -32.5-48.2% and the II was 0.10. The mean concentration of cTn decreased by -6.4% (hs-cTnT) and -7.6% (hs-cTnI) during HD treatment. The CVDIFF-I and CVDIFF-G was 4.2 and 6.3% for hs-cTnT, and 10.7 and 9.4% for hs-cTnI. The RCVDIFF was -18.2-5.4% (hs-cTnT) and -39.0-23.8% (hs-cTnI), respectively, and the IIDIFF-values were 0.7 and 1.3.
CONCLUSIONS: The CVI and CVG are similar to earlier findings. Mean hs-cTn concentrations decreased during HD. The within-subject hs-cTn variation during HD is similar to the between-subject variation, i.e. determining a cut-off value for hs-cTn changes during HD may be useful.
METHODS: Serum samples were collected from 20 patients before and after 10 consecutive HD treatments. cTn were measured using the hs-cTnT (Roche Diagnostics) and the hs-cTnI (Abbott Diagnostics). The CVA, CVI, CVG, CVDIFF-I and CVDIFF-G, were estimated using nested ANOVA.
RESULTS: The within-week data showed hs-cTnT CVA, CVI and CVG of 1.6, 7.3 and 94.4%. Reference change values (RCV) were estimated to -18.7-23.0%. The Index of individuality (II) was 0.08. Corresponding values for hs-cTnI were 5.3, 13.2 and 142.4%, whilst the RCV was -32.5-48.2% and the II was 0.10. The mean concentration of cTn decreased by -6.4% (hs-cTnT) and -7.6% (hs-cTnI) during HD treatment. The CVDIFF-I and CVDIFF-G was 4.2 and 6.3% for hs-cTnT, and 10.7 and 9.4% for hs-cTnI. The RCVDIFF was -18.2-5.4% (hs-cTnT) and -39.0-23.8% (hs-cTnI), respectively, and the IIDIFF-values were 0.7 and 1.3.
CONCLUSIONS: The CVI and CVG are similar to earlier findings. Mean hs-cTn concentrations decreased during HD. The within-subject hs-cTn variation during HD is similar to the between-subject variation, i.e. determining a cut-off value for hs-cTn changes during HD may be useful.