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

Acad Emerg Med. 2004 Sep;11(9):979-81. doi: 10.1197/j.aem.2004.03.022.


Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Coronary Disease / blood
  • Coronary Disease / etiology*
  • Humans
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis
  • Risk Factors
  • Troponin I / blood*


  • Biomarkers
  • Troponin I