Impact of hemodialysis on the level of high-sensitivity cardiac troponins T in patients with end-stage renal disease.
Bibliographic record
Abstract
AIM: The majority of patients with end-stage renal disease have chronically elevated concentrations of troponins, thus obscuring the diagnosis of myocardial infarction. We conducted a prospective study to examine the impact of hemodialysis on the level of high-sensitivity cardiac troponins T in asymptomatic patients with end-stage renal disease. METHODS: High-sensitivity cardiac troponins T were measured in 43 patients, before and after three dialysis sessions, over a one week period. RESULTS: Following dialysis, an average decrease of 7.6 pg/mL in high-sensitivity cardiac troponin T levels was observed which represents a 10.3% drop from baseline. Mutlivariable mixed linear regression models taking into account dialysis session (session 1, 2 or 3), sampling moment (before and after dialysis) and repeated measures on individuals revealed that the presence of coronary artery disease and elevated body mass index were associated with higher high-sensitivity cardiac troponin T levels when the other variables were held constant (CAD: β [fixed effect estimate]=31.13 pg/mL, P=0.022, 95%CI 4.46-57.80; body mass index: β=2.57 kg/m2, P=0.008, 95%CI 0.68-4.46). The significant fixed effect estimate for the interaction between gender and sampling moment indicated that the drop in high-sensitivity cardiac troponin T levels following dialysis was greater for women than for men (β=5.75, P=0.049, 95% CI 0.02-11.47). When controlling for the variables mentioned above, this analysis confirmed that hemodialysis accounted for an 11.31 pg/mL decrease in high-sensitivity cardiac troponin T levels (P<0.001, 95%CI -15.99 - -6.62) and that the values were higher in the first dialysis session than in the third (P=0.007; 95%CI 1.62-9.79). Ten patients (23%) were found to have no decrease or an increase in troponin levels after hemodialysis. CONCLUSION: In stable asymptomatic patients with end-stage renal disease, we have shown that hemodialysis reduces the blood concentration of high-sensitivity cardiac troponins T by at least 10%. Further studies are needed to confirm these results and determine their prognostic significance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".