CARDIAC TROPONINS IN PATIENTS WITH RENAL DYSFUNCTION

Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) were measured in 198 patients with renal dysfunction [132 men: median (range) age 66 .1 (8.2-90.3) years], cTnT was measured by two methods: ELISA and Enzy mun (Boehringer Mannheim UK, Lewes, UK), both with a detection limit o f 0.05 mu g/L in 179 and 78 patients, respectively. cTnI was measured in 80 patients by the OPUS plus and OPUS Magnum systems (Dade-Behring, Milton Keynes, UK) with a detection limit of 0.5 mu g/L. Patients wer e classified as having chronic renal impairment (CRI), chronic renal f ailure (CRF), acute renal failure including those with multiple organ failure on renal replacement therapy (ARF), and patients with chronic renal failure treated with haemodialysis (HD). Cardiac troponins were detectable in the serum of patients with renal dysfunction. cTnT was d etectable in 113/179 (63.1%) and 33/78 (42.3%) by the ELISA and Enzymu n methods respectively. cTnI was detectable in 17/80 (21.3%). cTnT (EL ISA and Enzymun methods) and cTnI were detectable with increased frequ ency in the CRF, HD and ARF patient groups compared with the CRI group . Cardiac troponin concentrations did not correlate with serum creatin e kinase (CK) activity, CK-MB, or urea or creatinine levels. Serial ca rdiac troponin measurements may be required to confirm or exclude a di agnosis of acute coronary syndromes in patients with renal dysfunction .