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Acad Emerg Med. 2004 Sep;11(9):979-81.

Prevalence of elevated troponin I in end-stage renal disease patients receiving hemodialysis.

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  • 1Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA.



Patients with end-stage renal disease (ESRD) who are receiving hemodialysis have an increased incidence of atherosclerotic heart disease. Currently, there is considerable controversy regarding the significance of elevated cardiac troponin I (cTnI) levels in patients with ESRD. The objective of this study was to examine the prevalence of elevated cTnI levels in asymptomatic patients with ESRD on hemodialysis.


This was a prospective cohort study at an urban hospital outpatient dialysis center. Serum was collected pre- and postdialysis from patients on dialysis at this center over a two-week period. Samples were batched and analyzed for cTnI using the Asxym fluorescent antibody test. An elevated cTnI level was defined as >0.8 ng/dL.


Predialysis cTnI levels ranged from <0.1 to 0.7 ng/dL, and postdialysis cTnI levels ranged from <0.1 to 0.6 ng/dL. None of the patients had a cTnI level >0.8 ng/dL.


cTnI levels are not falsely elevated in patients with ESRD on hemodialysis. In a patient with ESRD, myocardial injury should be suspected if his or her cTnI level is >0.8 ng/dL.

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