Relationship between glomerular filtration rate, cardiac troponin T and renal anemia
PAN Dezhang1, LONG Zhijun2, NIE Shanhua3, PANG Yutao1, XIAO Ruifeng1
1. Department of Nephrology, General Hospital of Central Theater Command, Wuhan 430070, 2. Health Team of Shaoyang Branch of Hunan Provincial Corps, Chinese People's Armed Police Force, Shaoyang 422000, 3. Hubei Provincial Corps Hospital, Chinese People's Armed Police Force, Wuhan 430064,China
Abstract：Objective To explore the relationship between cardiac troponin T (cTnT),glomerular filtration rate (GFR),and renal anemia (RA) respectively by analyzing levels of three indexes among hemoglobin (Hgb), GFR and cTnT in non-dialysis patients with chronic kidney disease (CKD). Methods The levels of Hgb, cTnT and GFR of 891 inpatients with non-dialysis CKD in our hospital were analyzed. According to Hgb level, patients were divided into four anemia groups of no, mild, moderate and severe, and levels of GFR and cTnT were observed respectively in each group. According to GFR level,patients were divided into CKD1-5 stages,and the Hgb level at each stage of CKD and the proportion of Hgb level below 90g/L were observed and analyzed. Results In non-dialysis patients, the GFR (ml/min) levels were 62.6(46.3,82.6), 37.9(25.5,51.4), 20.7(14.7,29.9), 16.4(13.0,27.4) in no, mild, moderate and severe anemia group, respectively. The GFR levels of different anemia groups showed significant differences with statistical significance(P<0.05). The GFR levels decreased gradually with the aggravation of anemia. Pearson-test showed a positive linear relationship between GFR and Hgb (R=0.653, P<0.05).The levels of cTnT (ng/ml) were 0.010(0.006,0.015), 0.016(0.011,0.028),0.028 (0.016,0.045), 0.036(0.021,0.046) in no, mild, moderate and severe groups, respectively. CTnT level increased gradually with the aggravation of anemia. Pearson-test showed a negative linear relationship between cTnT and Hgb (R=-0.300, P< 0.05).With increased CKD staging, the average level of Hgb gradually decreased, and the proportion of Hgb below 90 g/L gradually increased. Conclusions Actively ameliorating anemia in non-dialysis patients with CKD can delay renal function progression and improve myocardial status.
Levey A S, Jong P E, Coresh J, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report[J]. Kidney Int, 2011,80(1):17-28.
[5]
Higashiura M, Ohya M, Tanaka Y, et al. Correlation between haemoglobin level and type of erythropoiesis-stimulating agent at initiation of haemodialysis[J]. INT J Clin pharm-NET, 2020, 42(2): 635-641.
Loutradis C, Skodra A, Georgianos P, et al. Diabetes mellitus increases the prevalence of anemia in patients with chronic kidney disease: A nested case-control study[J]. World J Nephr, 2016, 5(4): 358.
[8]
Yi S W, Moon S J, Yi J J. Low-normal hemoglobin levels and anemia are associated with increased risk of end-stage renal disease in general populations: a prospective cohort study[J]. Plos one, 2019, 14(4): e0215920.
[9]
Tanaka K, Watanabe T, Takeuchi A, et al. Cardiovascular events and death in Japanese patients with chronic kidney disease[J]. Kidney int, 2017, 91(1): 227-234.
[10]
Vestergaard S V, Heide J U, Haalen H, et al. Risk of anemia in patients with newly identified chronic kidney disease-a population-based cohort study[J]. Clin Epidemiol, 2020, 12: 953.
[11]
Portolés J, Gorriz J L, Rubio E, et al. The development of anemia is associated to poor prognosis in NKF/KDOQI stage 3 chronic kidney disease[J]. BMC Nephr, 2013, 14(1): 1-9.
[12]
Tsuruya K, Yoshida H, Suehiro T, et al. Erythropoiesis-stimulating agent slows the progression of chronic kidney disease: a possibility of a direct action of erythropoietin[J]. Renal Failure, 2016, 38(3): 390-396.
Kozinski M, Krintus M, Kubica J, et al. High-sensitivity cardiac troponin assays: from improved analytical performance to enhanced risk stratification[J]. Crit Rev Clin Lab Sci, 2017, 54(3): 143-172.
[15]
Morandini M, Berto A. The organizational impact of high-sensitivity troponin (hs-cTn) in the laboratory network for acute coronary syndrome (ACS)[J]. Italian J Labora Med, 2017,13(3-4):187-193.
[16]
Hof D, Eckardstein A. High-sensitivity troponin assays in clinical diagnostics of acute coronary syndrome[J].Calcium EF Hand Superfa, 2019,40: 645-662.
[17]
Park K C, Gaze D C, Collinson P O, et al. Cardiac troponins: from myocardial infarction to chronic disease[J]. Cardiovasc Res, 2017, 113(14): 1708-1718.
2022, Vol. 33 
