Zoraida Corte1, Camino García2, Rafael Venta3. 1. Service of Biochemistry, Hospital San Agustín, Avilés, Principado de Asturias, Spain. 2. Service of Nephrology, Hospital San Agustín, Avilés, Principado de Asturias, Spain. 3. Service of Biochemistry, Hospital San Agustín, Avilés, Principado de Asturias, Spain Department of Biochemistry and Molecular Biology. University of Oviedo, Principado de Asturias, Spain rafael.venta@sespa.princast.es.
Abstract
BACKGROUND: Serum cardiac troponin T concentrations are important predictors of cardiovascular and all-cause mortality in end-stage renal disease. In patients with end-stage renal disease, assessment of serial results is essential to distinguish between a cardiovascular event and chronic elevation. We employed a high-sensitivity serum cardiac troponin T assay to evaluate the long-term biological variation in end-stage renal disease patients and in healthy individuals; these biological variation data were used to define the reference change value and the analytical goals. METHODS: Serum samples were collected from 18 end-stage renal disease patients in steady-state conditions, one per month for 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. Biological variation data were derived using analysis of variance. RESULTS: Baseline serum cardiac troponin T concentrations in end-stage renal disease patients were above the 99th percentile of the healthy population and increased with duration of haemodialysis. For end-stage renal disease patients, within-subject (CVI) and between-subject (CVG) coefficients of variation were 14.7 and 77.8%, respectively, whereas these were 5.9 and 30.4%, respectively, for healthy individuals. The derived two-tailed and one-tailed reference change values were 44.1 and 37.1%, respectively, for end-stage renal disease patients, and 21.6 and 18.2% for healthy subjects. CONCLUSIONS: For appropriate clinical management of end-stage renal disease patients in the context of a cardiovascular event, regular monitoring of serum cardiac troponin T concentrations could be important in order to allow future comparison through reference change value. Biological variation data in end-stage renal disease patients were significantly higher than for healthy individuals; therefore, the use of proper reference change value data is recommended. Moreover, the observed CVI values provide demanding imprecision goals for current technology.
BACKGROUND: Serum cardiac troponin T concentrations are important predictors of cardiovascular and all-cause mortality in end-stage renal disease. In patients with end-stage renal disease, assessment of serial results is essential to distinguish between a cardiovascular event and chronic elevation. We employed a high-sensitivity serum cardiac troponin T assay to evaluate the long-term biological variation in end-stage renal diseasepatients and in healthy individuals; these biological variation data were used to define the reference change value and the analytical goals. METHODS: Serum samples were collected from 18 end-stage renal diseasepatients in steady-state conditions, one per month for 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. Biological variation data were derived using analysis of variance. RESULTS: Baseline serum cardiac troponin T concentrations in end-stage renal diseasepatients were above the 99th percentile of the healthy population and increased with duration of haemodialysis. For end-stage renal diseasepatients, within-subject (CVI) and between-subject (CVG) coefficients of variation were 14.7 and 77.8%, respectively, whereas these were 5.9 and 30.4%, respectively, for healthy individuals. The derived two-tailed and one-tailed reference change values were 44.1 and 37.1%, respectively, for end-stage renal diseasepatients, and 21.6 and 18.2% for healthy subjects. CONCLUSIONS: For appropriate clinical management of end-stage renal diseasepatients in the context of a cardiovascular event, regular monitoring of serum cardiac troponin T concentrations could be important in order to allow future comparison through reference change value. Biological variation data in end-stage renal diseasepatients were significantly higher than for healthy individuals; therefore, the use of proper reference change value data is recommended. Moreover, the observed CVI values provide demanding imprecision goals for current technology.
Authors: Christian D Peters; Krista D Kjaergaard; Kent L Christensen; Bo M Bibby; Bente Jespersen; Jens D Jensen Journal: BMC Nephrol Date: 2020-10-28 Impact factor: 2.388