The Prevalence of Elevated Serum Troponin T and its Association with Left Ventriular Hypertrophy in Patients with Chronic Kidney Disease in Ilorin

Abstract

Background: Left ventricular hypertrophy is the
most frequent cardiac alteration in chronic kidney
disease patients and it is associated with poor
outcome. Troponin T, a contractile protein has been
found to be elevated in chronic kidney disease patients
who have no ongoing myocardial necrosis. This study
assessed the clinical relationship between serum
elevated troponins T in patients with chronic kidney
disease and LVH in our patient population.
Methods: This was an hospital- based study crosssectional
study of 110 patients with CKD who were
seen in the nephrology clinic, the renal ward and the
general medical ward at the University of Ilorin
Teaching Hospital and 110 age and sex matched
controls who had no CKD. Informed consent and
relevant information were obtained using a study
proforma. Biochemical parameters (Troponin T,
serum creatinine, lipid profile) of both patients and
controls were analyzed. Electrocardiogram and
Echocardiogram were carried out on all patients.
Troponin T assay was done using ELISA third
generation kit while electrocardiogram was done
using the GE MAC 1200 ST Electrocardiogram.
Echocardiogram was done using the Sonoscope 2D
model machine. Data was analysed using descriptive
and inferential statistics on an SPSS software version
23. Level of statistical significance was set at p <
0.05.

Results: The mean age of the patients with CKD
was 55±14 years while that of the control was 52±14
years. The median value of creatinine in the cases
category was 160(121-224) μmol/l while the median
value in the control participants was 74(51-84)μmol/
l. The median eGFR was 39(26-52)ml/min/1.73m2 in
the cases, while in the control participants, it was
118(87-143) ml/min/1.73m2. The median value for
serum troponin T was 0.78(0.15-1.25) μg/l in the case
participants. This was significantly higher than the
control participants who had a median value of
0.09(0.07-0.09) μg/L. P<0.001. Eighty-one (91.4%)
of the eighty-six participants with CKD who had
elevated troponin T had LVH.
Conclusion: Cardiac Troponin T is elevated in
chronic kidney disease patients particularly dialysis
patients. Cardiac troponin T should be incorporated
as a screening tool in patients with CKD.