Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2009     Vol 34     No 3-4
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      UDK 616.61-008.6 ; 616.1:577.11

ISSN 0350-2899, 34(2009) Br.3-4 p.169-177


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


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
Note: full text in Serbian

      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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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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