The effect of di̇alysi̇s on cardi̇ovascular markers

Chronic kidney disease, is a group of diseases that occur chronic inflammatory and degenerative changes in the renal parenchyma. Chronic renal failure is a table resulting from the progression of chronic kidney disease. Conservative treatment and renal replacement therapy is applied in patients with chronic renal failure. Cardiovascular disease (CVD) is the most important cause of morbidity and mortality in patients in all stages of chronic kidney disease and receiving renal replacement therapy. In this study; we aimed to investigate the effect of a single HD session on cardiovascular markers used frequently, by evaluating plasma levels of NT-proBNP, TnI, CK-MB before and after hemodialysis. 78 hemodialysis patients and 30 healthy controls were enrolled into the study. Demographic and dialysis datas of patients were recorded before study. Samples were taken in lithium heparin tube for all participants and plasma NT-proBNP, TnI, CK-MB concentrations were measured by immunoassay. There were no significant differences in demographic datas between patients and control group. In the control group, plasma NT-proBNP, TnI, CK-MB concentrations were (x̄ ± SD) 80.40 ± 24.92 ng/l, 0.005 ± 0.06 ng/ml, 2:21 ± 1.24 ng/ml respectively. Plasma NT-proBNP, TnI, CK-MB concentrations were 10765.71±8525.20 ng/L, 0.0142±0.0174 ng/ml, 2,21±1,24 ng/ml before hemodialysis and 8816.58±7715.65 ng/l, 0.0278±0.0304 ng/ml, 2.41±1.69 ng/ml after hemodialysis respectively. Plasma NT-proBNP and TnI concentrations were significantly higher in patients compared to the control group (p <0,05). After hemodialysis; there was a significant decrease in plasma concentration of NT-proBNP (p<0,05), and a significant increase in plasma TnI concentration (p<0,05). There were no significant changes in plasma CK-MB concentrations between all groups (p>0,05). İn conclusion; we belived that, an intra-dialysis rise in cTnI is associated with an decreased myocardial perfussion and this shows that the hemodialysis procedure itself, causes microinfarcts in myocardium and elevated cardiac troponin levels. We suggest that; these patients should be followed more closely for CVD in terms of close and long-term. Key Words: Chronic kidney disease, Cardiovascular disease, NT-proBNP, TnI, CK-MB