Serum levels of cardiac enzymes before and after renal transplantation

Background : Cardiac troponins are very sensitive and specific indicators of myocardial damage; however, they are sometimes found to be increased in patients with end‐stage renal disease (ESRD). Hypothesis : The aim of this study was to determine cardiac troponin I (cTpI) and creatine kinase myocardial isoform (CK‐MB) levels and to assess their diagnostic and prognostic importance before and after renal transplantation. Methods : Thirty‐four patients with ESRD (mean age 31.8 ± 8.6 years, 11 women) were enrolled. Serum levels of cTpI and CK‐MB were measured pre‐ and postoperatively on Days 1, 7, and 30. Patients were followed up for cardiac events, and possible myocardial damage was investigated by exercise thalli‐um‐201‐labeled myocardial perfusion scintigraphy. Mean cTpI levels were 0.24 ± 0.11 ng/ml (preoperative), and 0.34 ± 0.27 ng/ml (Day 1), 0.26 ± 0.11 ng/ml (Day 7), and 0.28 ± 0.30 ng/ml (Day 30). Results : Compared with preoperative levels, cTpI was increased in 16 (47%), decreased in 6 (17.6%), and did not change in 12 (35.4%) patients. However, the increase did not exceed the myocardial infarction reference level of 2.3 ng/ml in any patient. Mean CK‐MB levels were 12.6 8.7U/l (preoperative), and 16.8 ± 9.2U/l (Day 1), 16.3 ± 8.1U/l (Day 7), and 13.3 ± 6.6U/l (Day 30). Creatine kinase‐MB was increased to above normal levels of 24 U/l in 13 (38.2%) patients on postoperative Days 1 or 7, and decreased to normal at the end of Month 1. No cardiac events occurred, and there was no abnormality in any patient on thallium scintigraphy. Conclusion : There was no significant difference in the levels of cTpI in patients with ESRD without cardiac events before and after renal transplantation (p > 0.05). Our findings show that cTpI has very high sensitivity and specificity for detecting cardiac damage in patients with ESRD after renal transplantation.