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| UDK 616.61-008.6 ; 616.1:577.11 |
ISSN 0350-2899, 34(2009) Br.3-4 p.169-177 |
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Review Use of cardiac biomarkers for diagnosis and prognosis of cardiovascular events in patients with chronic kidney disease (Upotreba kardijalnih biomarkera u dijagnozi i prognozi kardiovaskularnih događaja kod bolesnika sa hroničnom bubrežnom insuficijencijom) Biserka Tirmenštajn-Janković (1), Dušan Bastać (2) (1) Zdravstveni centar Zaječar, Služba za nefrologiju i hemodijalizu (2) Privatna internistička ordinacija "Dr Bastać", Zaječar |
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| Summary: Cardiovascular disease is the most frequent single cause of mortality among patients with end-stage renal disease (ESRD), accounting for nearly one half of all deaths. An excessive cardiovascular risk in ESRD patients is related to a very high incidence of left ventricular hypertrophy, cardiomyopathy, heart failure, and coronary artery disease. The alarming rate of cardiovascular events demands an accurate risk stratification to determine ESRD patients at higher risk and therefore needing an intensive surveillance and treatment. Identifying serum biomarkers that can predict adverse events is very important in profiling cardiovascular risk of these patients. In recent years many studies have been performed and proved an important role of several biomarkers. These include markers of myocardial necrosis such as cardiac troponin T and I, markers of heart failure such as B-type natriuretic peptide and its associated inactive N-terminal fragment, markers of systemic inflammation - C-reactive protein, an endogenous inhibitor of nitric oxide synthase - asymmetric dimethyl arginin, and homocysteine. Numerous past biomarker investigations have focused on either a single marker or comparison of markers of the same group (i.e., markers of myocardial necrosis). However, an increasing number of studies have demonstrated the potential benefits of using a panel of cardiac markers for risk stratification of ESRD patients. Although further work is needed to identify the most appropriate threshold values and to determine the optimum algorithm for clinical use of each marker in this population, the potential clearly exists to stratify ESRD patients into layered groups with quantifiable risk and perhaps in the future to target specific therapies to each patient subgroup according to their risk and cardiovascular pathophysiologic profile. Key words: cardiac biomarkers, end-stage kidney disease Napomena:
kompletan tekst rada na srpskom jeziku |
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Corresponding Address: Biserka Tirmenštajn-Janković Služba za nefrologiju i hemodijalizu Zdravstveni centar Zaječar 19000 Zaječar |
Paper received: 17. 04. 2009 Paper accepted: 18. 12. 2009 Published online: 30. 01. 2010. |
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