Survival of patients on the kidney transplant wait list

Relationship to cardiac troponin T

LaTonya Hickson, Fernando G Cosio, Ziad M El-Zoghby, J. M. Gloor, Walter K Kremers, Mark D Stegall, M. D. Griffin, Allan S Jaffe

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Patients waiting for a kidney transplant have high mortality despite careful preselection. Herein, we assessed whether cardiac troponin T (cTnT) can help stratify risk in patients selected for kidney transplantation. cTnT levels were measured in all kidney transplant candidates but the results were not used for patient selection. Among 644 patients placed on the kidney waiting list from 9/2004 to 12/2006, 61% had elevated cTnT levels (>0.01 ng/mL). Higher levels related to diabetes, longer time on dialysis, history of cardiovascular disease and low serum albumin. High cTnT also related to cardiac anomalies, including left ventricular hypertrophy (LVH), wall motion abnormalities and stress-inducible ischemia by dobutamine echo (DSE). However, 54% of patients without these cardiac findings had elevated cTnT. Increasing cTnT levels were associated with reduced survival (HR = 1.729, CI (1.25-2.39), p = 0.01) independently of low serum albumin (0.449 (0.24-0.83), p = 0.011) and history of stroke (3.368 (1.47-7.73), p = 0.0004). The results of the DSE and/or coronary angiography did not relate significantly to survival. However, high cTnT identified patients with abnormal echo findings and poor survival. Wait listed patients with normal cTnT have excellent survival irrespective of other factors. In contrast, high cTnT levels are strongly predictive of poor survival in the kidney transplant waiting list.

Original languageEnglish (US)
Pages (from-to)2352-2359
Number of pages8
JournalAmerican Journal of Transplantation
Volume8
Issue number11
DOIs
StatePublished - Nov 2008

Fingerprint

Troponin T
Transplants
Kidney
Survival
Waiting Lists
Serum Albumin
Dobutamine
Left Ventricular Hypertrophy
Coronary Angiography
Kidney Transplantation
Patient Selection
Dialysis
Cardiovascular Diseases
Ischemia
Stroke
Mortality

Keywords

  • Biomarker
  • Cardiovascular
  • Patient survival
  • Survival
  • Waiting list

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Survival of patients on the kidney transplant wait list : Relationship to cardiac troponin T. / Hickson, LaTonya; Cosio, Fernando G; El-Zoghby, Ziad M; Gloor, J. M.; Kremers, Walter K; Stegall, Mark D; Griffin, M. D.; Jaffe, Allan S.

In: American Journal of Transplantation, Vol. 8, No. 11, 11.2008, p. 2352-2359.

Research output: Contribution to journalArticle

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