Abstract: SA-PO902
The Hemodialysis Outcome Assessment: Troponin I Measurement Study
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Collister, David Thomas, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Mazzetti, Andrea Elisa, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Bhalerao, Anuja, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Kavsak, Peter, Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada
- Brimble, K. Scott, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Walsh, Michael, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
Background
The impact of hemodialysis (HD) on cardiac biomarkers is unclear. The objectives of this study were to 1) To evaluate the intradialytic variability of high sensitivity troponin I (hs-TnI), galectin 3 (gal3) and human fatty acid binding protein (hfabp) and 2) To determine the factors associated with these changes.
Methods
In this prospective cohort study, hs-TnI, gal3 and hfabp were measured pre and post-HD for one week every month for 6 months in 178 prevalent adult HD patients with at least 2 HD treatments per week from a tertiary HD unit in Hamilton, Canada. Multilevel linear regression with HD treatments clustered within patients was performed to determine independent predictors of post-dialysis hs-TnI, gal3 and hfabp.
Results
The median (interquartile range) difference in pre and post-HD hs-TnI was -1ng/L (-2ng/L to +1ng/L) and the mean (standard deviation) differences in gal3 and hfabp were -38.06ng/mL (16.97ng/mL) and -20.85ng/mL (11.40ng/mL) respectively. Increases in hs-TnI, gal3 and hfabp were associated with ultrafiltration with B coefficients of +0.991ng/L, +1.053ng/mL and +1.877ng/mL per liter of fluid removal respectively. A change in hs-TnI was not associated with the total blood processed per HD session while decreases in gal3 and hfabp were associated with the total blood processed with B coefficients of -0.139ng/mL and -0.072ng/mL per liter of blood processed respectively. Dialysis length was associated with a decrease in all three cardiac biomarkers with B coefficients of -0.025ng/L for hs-TnI, -0.020ng/mLfor gal3 and -0.011mg/mL for hfabp per minute of HD.
Conclusion
Gal3 and hfabp decrease during dialysis while hs-TnI does not change. Increases in hs-TnI, gal3 and hfabp during HD are associated with ultrafiltration. Decreases in gal3 and hfabp during HD are associated with the total blood processed per HD session while hs-TnI is not.
Funding
- Commercial Support – Abbott Diagnostics, Roche Modular