End-stage Renal Disease Clinical Trial
Official title:
Study of High Sensitive Troponin-I Level in End-stage Renal Disease Patients Receiving Hemodialysis
This study objective is to compare the high sensitive troponin-I level in end-stage renal disease patients received hemodialysis without acute cardiovascular event with healthy population. The investigators also determine the effect of hemodialysis on troponin I level as the secondary objective.
Human cardiac Troponin I (cTnI) is an composition of Troponin which is found in heart muscle
cells. Molecular weight of cTnI is 23,875 Dalton consisting of 209 amino acids. [1,2] The
cTnI have been used in the diagnosis of acute myocardial infarction(AMI). [3,4,5] According
to ESC / ACCF / AHA / WHF, diagnosis of acute myocardial infarction rely on the data from
clinical symptoms, Electrocardiogram (EKG) changes in the specific pattern, such as
ST-segment elevation / depression, new left bundle branch block, and cardiac biomarker level
rise over the 99th percentile upper reference limit, which makes the cTnI level was used to
help in making diagnosis for patient coming with symptoms of angina in emergency room.
The current cTnI detecting test has developed more and more high sensitive(called
"high-sensitive troponin-I; hsTnI") which can detected in the range 10-50,000 pg / ml (ng /
L) [6], and it can detected cTnI level even in normal people unlike cTnI, which only
reported positive or negative or lower than the limit of detection. Due to ARCHITECT stat
High sensitive Troponin-I (Abbott diagnostic) capabilities, hsTnI level can be detected in
normal people up to 96 percent.[7] The reference range of hsTnI which has been researched by
Apple FS, et al.(2012) studying the 19 types of cardiac troponin I and T measurement was
established. The 99th percentile values for general healthy population without hypertension,
diabetes, kidney disease and myocardial infarction, aged 18-64 years was 36 ng / L in men (N
= 272), 15 ng / L in women (N = 252) [7].
However, research to find the reference of hsTnI in some groups , especially in patients
with kidney disease is still limited and the diagnosis of acute myocardial infarction also
use the 99th percentile as the reference source which was researched in healthy
population[7] which makes it difficult to interpret. Sometimes doctors may concluded that
patients with rising hsTnI because of kidney disease. According to the research in the next
section, there are both support and against in this idea. Therefore, the researchers aim to
study hsTnI in patients with end-stage renal disease received hemodialysis compare with
normal population.
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Observational Model: Cohort, Time Perspective: Cross-Sectional
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