The short-term effect of hemodialysis in the level of high-sensitive cardiac troponin T: A systematic review

AbstractIntroduction:
Patients with end-stage renal disease (ESRD) have an increased risk ofcardiovascular disease, but interpreting cardiac troponin is difficult in this population.The effect of renal replacement therapy (RRT) is important to consider when inter-preting serial cardiac troponin T (cTnT) results for patients with ESRD suspected ofacute coronary syndrome (ACS).
The aim of this systematic review is to answer howlow-flux hemodialysis (LF-HD), high-flux hemodialysis (HF-HD), and hemodiafiltration(HDF) affect the blood concentration of high-sensitive cardiac troponin T (hs-cTnT).Method:Several databases were searched and identified records were evaluatedindependently by two of the authors. Pre- and postdialysis hs-cTnT concentrationstogether with other relevant data were extracted from the included studies. Thequality (potential bias and applicability issues) were assessed for each of the includedstudies.
Results:The literature search identified 2,540 records and 15 studies were included.The relative pre- to postdialysis change of hs-cTnT varied from41 to 29%. LF-HDincreased the hs-cTnT concentration with relative changes between 2 and 17%. HDFdecreased the concentration with relative changes from41% to9%. Bothincreases and decreases were seen for HF-HD (16% to 12%).
Discussion/Conclusion:In this systematic review, we found LF-HD to increase thehs-cTnT concentration and HDF to decrease the concentration. Results for HF-HDand unspecified HD are more heterogeneous. Because of the differences betweenthe included studies, a meta-analysis was not meaningful. This systematic review canhelp with the assessment of patients with ESRD suspected of ACS in relation tohemodialysis/HDF treatment.