Troponins in Acute Kidney Injury

Song, David S.; Zoysa, Janak R de; Ng, Alexander K.; Chiu, Weldon

doi:10.3109/0886022x.2011.623440

Cited by 24 publications

(28 citation statements)

References 20 publications

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“…ET-1 also upregulates NT-proBNP, which is associated with hypotension, hyponatremia and venous congestion [45, 46], variables associated with the hemodynamic explanation of CRS-1. TnI was also found associated to the worsening of renal function in ACS; previous studies demonstrated that AKI alone can raise the levels of TnI indicating that AKI can also lead to a cardiac injury and that these effects seem to be bidirectional [47]. …”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Ortega-Hernandez

Springall

Sánchez‐Muñoz

et al. 2017

BMC Cardiovasc Disord

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BackgroundAcute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. The role of cytokines and other mediators is unknown in AKI induced by an ACS (ACS-AKI), leading to several unanswered questions. The worsening of renal function is usually seen as a dichotomous phenomenon instead of a dynamic change, so evaluating changes of the renal function in time may provide valuable information in the ACS-AKI setting. The aim of this study was to explore inflammatory factors associated to de novo kidney injury induced by de novo cardiac injury secondary to ACS.MethodsOne hundred four consecutive patients with ACS were initially included on the time of admission to the Coronary Unit of the Instituto Nacional de Cardiología in Mexico City, from February to May 2016, before any invasive procedure, imaging study, diuretic or anti-platelet therapy. White blood count, hemoglobin, NT-ProBNP, troponin I, C-reactive protein, albumin, glucose, Na+, K+, blood urea nitrogen (BUN), total cholesterol, HDL, LDL, triglycerides, creatinine (Cr), endothelin-1 (ET-1), leukotriene-B4, matrix metalloproteinase-2 and -9, tissue inhibitor of metalloproteinases-1, resolvin-D1 (RvD1), lipoxin-A4 (LXA4), interleukin-1β, −6, −8, and −10 were measured. We finally enrolled 78 patients, and subsequently we identified 15 patients with ACS-AKI. Correlations were obtained by a Spearman rank test. Low-rank regression, splines regressions, and also protein–protein/chemical interactions and pathways analyses networks were performed.ResultsPositive correlations of ΔCr were found with BUN, admission Cr, GRACE score, IL-1β, IL-6, NT-ProBNP and age, and negative correlations with systolic blood pressure, mean-BP, diastolic-BP and LxA4. In the regression analyses IL-10 and RvD1 had positive non-linear associations with ΔCr. ET-1 had also a positive association. Significant non-linear associations were seen with NT-proBNP, admission Cr, BUN, Na+, K+, WBC, age, body mass index, GRACE, SBP, mean-BP and Hb.ConclusionInflammation and its components play an important role in the worsening of renal function in ACS. IL-10, ET-1, IL-1β, TnI, RvD1 and LxA4 represent mediators that might be associated with ACS-AKI. IL-6, ET-1, NT-ProBNP might represent crossroads for several physiopathological pathways involved in “de novo cardiac injury leading to de novo kidney injury”.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0640-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Ortega-Hernandez

Springall

Sánchez‐Muñoz

et al. 2017

BMC Cardiovasc Disord

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“…Other disease processes in the study population may have influenced the measured cTnI concentration. Human patients with renal insufficiency can have measurable cTnI concentrations, even in the absence of clinically suspected ischemia . Cardiac troponin I has been correlated with renal function in patients with chronic kidney disease .…”

Section: Discussionmentioning

confidence: 99%

“…Human patients with renal insufficiency can have measurable cTnI concentrations, even in the absence of clinically suspected ischemia. 53 Cardiac troponin I has been correlated with renal function in patients with chronic kidney disease. 54 The cause of increased cTnI concentration in renal disease is assumed to be multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Investigation of Cardiac Troponin I Concentration in Cows with Common Production Diseases

Varga

Angelos

Graham

et al. 2013

Veterinary Internal Medicne

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Background: Increased cTnI concentrations are associated with adverse outcomes in humans and animals. Limited information is available on the prognostic value of cTnI in cows.Objective: To measure cTnI in cows with noncardiac diseases and evaluate the association of cTnI concentration with adverse outcomes such as death or early removal from the herd.Animals: Thirty control and 53 diseased cows. Methods: Serum cTnI concentrations were determined with a point-of-care immunoassay. Cows were diagnosed anteor postmortem with metritis (n = 6), mastitis (n = 4), peritonitis (n = 6), LDA (n = 14), LDA and metritis (n = 4), pneumonia (n = 6), dystocia requiring cesarean section (n = 5), and downer cow syndrome (n = 8). Animal survival was determined for up to 2 months after presentation.Results: The immunoassay showed reliability for the detection of bovine cTnI. Cows with LDA and metritis (P < .05), peritonitis (P < .05), LDA (P < .001), dystocia requiring cesarean section (P < .01), and downer cow syndrome (P < .001) had higher cTnI concentrations than control cows. The odds of a negative outcome (death or culling) for cows with cTnI concentrations of ≥0.05, ≥0.1, ≥0.2, and ≥0.5 ng/mL were 2.4, 2.9, 4.8, and 6.2, respectively.Conclusion: Cows with noncardiac diseases may have some degree of myocardial injury. The magnitude of cTnI increased may assist clinicians in evaluating the risk of an adverse outcome and help guide decision-making regarding treatment and prognosis.

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“…However, after adjustment for confounders, preprocedural MA was still independently associated with a higher incidence of PMN in subjects with eGFR ≥60 ml/min, without MA, and undergoing (Table 4). Similarly, Song et al (2012) found that 32% of subjects (6/19) had troponin I and T concentrations above the 99th percentile of a reference population, without known confounders, resulting in elevated troponin levels. This suggests that impaired renal function disease influences plasma cardiac troponin levels in AKI as well as in chronic kidney failure.…”

Section: Discussionmentioning

confidence: 99%

A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention

Zhang

Meng

Zhao

et al. 2013

J. Zhejiang Univ. Sci. B

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Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary intervention (PCI). Contrast-induced acute kidney injury (CI-AKI) is a complex syndrome induced by exposure to intravascular contrast media (CM). Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI, and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis (PMN) after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects undertaking elective PCI. The levels of cardiac troponins (cTns), cTnI and cTnT, at baseline and on at least one occasion 18-24 h after PCI were measured. We also recorded serum levels of creatinine (SCr) and the urine albumin:creatinine ratio (ACR) before coronary angiography, and 24-48 h and 48-72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% (53/327) of subjects with cTns levels >99th to 599th percentile upper reference limit (URL). Twenty-seven patients (8.26%) developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN (20.8% versus 5.8%, respectively, P=0.001). Multiple logistic regression analysis revealed that pre-existing microalbuminuria (MA) was an important independent predictor of PMN (OR: 3.31; 95% CI: 1.26-8.65, P=0.01). However, there was no correlation between the incidence of CI-AKI and PMN (OR: 2.38; 95% CI: 0.88-6.46, P=0.09). We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.

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Troponins in Acute Kidney Injury

Cited by 24 publications

References 20 publications

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Preliminary Investigation of Cardiac Troponin I Concentration in Cows with Common Production Diseases

A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention

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