Cardiovascular risk markers in hemodialysis patients

Cardiovascular events are the main cause of death in hemodialysis patients. Nevertheless, acute myocardial infarction may be misdiagnosed in uremic patients, because typical markers have a high rate of false positivity. A recent two-year prospective study showed that predialytic high serum concentrations of troponin T and CK-MB mass were associated with high mortality, cardiac mortality, myocardial infarction and unstable angina (MACEs). We studied 16 uremic patients (13 M; 3 W) on standard HD and 6 patients (4 M; 2 W) on on-line HDF, who had been taking folic acid for at least three months. Patients who suffered from acute or chronic cardiac ischemic disease were excluded. Anthropometric parameters, pre and post-dialytic pH, HCO3 and electrolytes did not differ between the two groups. Kt/V and URR % were lower in conventional HD vs on-line HDF (p