Associations between estimated glomerular filtration rate and cardiac biomarkers

Abstract

Background: Chronic kidney disease (CKD) is associated with an increased cardiovascular disease (CVD) mortality risk. Elevation of cardiac biomarkers in patients with renal dysfunction is ambiguous in the diagnosis of CVD. The purpose of this study was to investigate the associations between estimated glomerular filtration rate (eGFR) and cardiac biomarkers, and the influence of renal dysfunction on the cardiac biomarkers.

Methods: We examined the cross-sectional associations of eGFR with cardiac troponin I (cTnI), creatine kinase (CK), CK-MB, lactic dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), and brain natriuretic peptide (BNP) in 812 adults and 215 child. Spearman correlation and logistic regression analysis were performed to evaluate the associations.

Results: For adults, lower eGFR _CKD-EPI had significantly higher cTnI, CK-MB, LDH, HBDH, and BNP. There were negative correlations between eGFR_CKD-EPI and cTnI, CK-MB, LDH, HBDH, and BNP. After adjustment for potential confounders, as compared with eGFR_CKD-EPI ≥ 90 mL/min/1.73 m² , eGFR_CKD-EPI < 60 mL/min/1.73 m² remained associated with a 2.83 (1.08-7.41) [ratio (95% CI)] times higher cTnI and a 6.50 (2.32-18.22) [ratio (95% CI)] times higher HBDH. For child, lower eGFR_Schwartz had significant higher CK and CK-MB. There were negative correlations between eGFR_Schwartz and CK, and eGFR_Schwartz and CK-MB. After adjustment for potential confounders, as compared with eGFR_Schwartz ≥ 90 mL/min/1.73 m² , eGFR_Schwartz < 90 mL/min/1.73 m² revealed no significant higher CVD biomarkers.

Conclusion: Reduced eGFR is associated with elevated cTnI and HBDH among adults without clinically evident CVD, but not child.

Keywords: cardiology; renal disease; troponin.