Evolution of high-sensitivity troponin-T and echocardiography parameters in patients undergoing high efficiency on-line hemodiafiltration versus conventional low-flux hemodialysis


Autoři: Isabelle Ethier aff001;  Dominique Auger aff002;  Martin Beaulieu aff003;  Ewa Wesolowska aff003;  Renée Lévesque aff001
Působiště autorů: Department of Nephrology, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada aff001;  Department of Cardiology, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada aff002;  Department of Biochemistry, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223957

Souhrn

Background and objectives

On-line hemodiafiltration (HDF) has been associated with better inflammatory markers profile and survival than low-flux hemodialysis (HD). This study aimed at determining the effect of HDF vs HD on hs-TnT and echocardiography parameters evolution at one year follow-up.

Method

Patients were randomized from 2007 to 2013 to HD or HDF in accordance with the CONvective TRAnsport STudy protocol initially as part of the Montreal cohort and subsequently as part of a local cohort. Pre-dialysis hs-TnT were analyzed at baseline and 1-year follow-up.

Results

A total of 54 HDF patients and 59 HD patients were included. At baseline, median hs-TnT value was 49 ng/L (IQR 31–89) in the HDF group vs. 60 ng/L (36–96) in the HD group (p = 0.370). At one year follow-up, median hs-TnT remained stable in the HDF group (p = 0.707 vs. baseline), but significantly increased to 62 ng/L (40–104) in the HD group (p = 0.021 vs. baseline). The median variation (delta) in hs-TnT values was -3 ng/L (IQR -7-+8) in the HDF group vs. +8 ng/L (-5 -+25) in the HD group (p = 0.042). In the HDF group, LVEF increased from 60.0% (IQR 55.0–65.0) at baseline to 65.0% (60.0–65.5) at 1-year follow-up (p = 0.040) whereas it remained stable in the HD group (LVEF of 60.0% [IQR 55.0–65.0] at baseline and 65.0% [55.0–65.0] at 1-year follow-up [p = 0.312]).

Conclusions

High-efficiency HDF is associated with stability in hs-TnT values, whereas low-flux HD is associated with significant increase in hs-TnT levels.

Klíčová slova:

Biomarkers – Convection – Coronary heart disease – Echocardiography – Chronic kidney disease – Medical dialysis – Troponin – Hemofiltration


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2019 Číslo 10