Some cardiovascular bio-markers in hypertensive andor diabetic patients with end stage renal disease

Abstract EN

Background : Patients with chronic renal failure (CRF) constitute a high risk subset of patients for developing coronary artery disease (CAD).

CAD in this population cannot be fully explained by high prevalence of the classical risk factors, but novel risk factors have been also invoked to play a significant role.

These observations mandate not only early diagnosis and treatment of cardiovascular disease (CVD) in patients with end stage renal disease (ESRD), but also periodical screening by properly selected test for CVD.

Aim : The current study determined serum troponin-I (Tn-I) concentration as a myocardial biomarker and plasma total homocyteine (tHcy) level as a novel endothelial atherogenic risk factor in patients with CRF.

The above stated biomarkers were correlated with some traditional risk factors as dyslipidemia, Diabetes Mellitus (DM) and/or Hypertension (HTN) in these patients.

Subjects and Methods : The study population was classified into the following groups: (A) Healthy controls consisted of 15 clinically normal blood donors or patients' relatives.

(B) CRF patients comprised thirty eight patients with CRF due to different renal intrinsic diseases.

According to the mode of treatment, these patients were classified into: i- Twenty CRF patients receiving conservative symptomatic treatment only and ii- Eighteen patients with CRF undergoing maintenance hem dialysis (HD).

All patient and control groups were subjected to determination of serum troponin-I and plasma homocysteine concentrations by the corresponding chemi-luminescence technique.

Results : There was a significant increase of the mean Tn-I level in HD group either with or without other cardiovascular risk factor(s) when compared to the healthy control or the conservative CRF group data.

Moreover, there was a significant difference of Tn-I levels between the conservative and control groups.

Serum Tn-I mean levels were also significantly higher in CRF patients with previous attacks of ischemic heart disease (IHD) compared to CRF patients without such history.

In addition, there was a significant increase of plasma tHcy levels in both in the conservative and the HD group either with or without other risk factors in comparison to the control group.

However, the difference between the two patient groups was not significant.

On the other hand, both the non ischemic and the ischemic CRF subgroups showed significant increase in tHcy levels compared to that of the control group but comparison between the two patient subgroups showed no significant difference as regards tHcy.

CRF patients with risk factor(s) (DM or HTN) were more prone to IHD development.