BACKGROUND:Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure.MATERIAL AND METHODS:We studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH), and gr B - 8 patients (without LVH).RESULTS:In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05) after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47) and weaker with hs CRP (r = 0.163). Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966), for NT-proBNP (r = 0.918) and for hs CRP (r = 0.859). It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng/mL, p < 0.05) and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg/mL, p < 0.05). Not find a significant difference in hs CRP in both groups.CONCLUSIONS:The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

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Secondary hyperparathyroidism is manifested early in the course of chronic kidney disease (CKD). Numerous studies have shown that serum magnesium significantly influences the function of the parathyroid glands. Serum levels of Mg in patients on regular hemodialysis were analyzed to establish their correlation with the levels of Ca, PO 4 , Alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH). A total of 72 test subjects (45 men and 27 women) were divided in two groups: 60 patients with diabetes mellitus and 12 patients without diabetes. Serum Mg levels were recorded immediately before and after intermediate weekly dialysis, using low-flux dialyzers with polysulfone membranes. Student`s ttest and linear regression analysis were used to analyze the available data. In both patient groups a significant disparity (p <0.005) was registered, confirming a positive correlation between serum Mg and serum total Ca, PO 4 , ALP and urea reduction ratio (URR%), much more pronounced with diabetic patients. A strong negative correlation between serum Mg and iPTH was observed. In patients with diabetes mellitus the average iPTH was 93,5 ± 33.12 pg/mL, 41,6% of which have hypermagnesaemia in addition. In non-diabetics the average iPTH was 433.52 ± 94.89 pg /mL; hypermagnesemia was detected in 21,6% of the patients. Higher, compared to the normal levels, of serum magnesium was observed in almost twice as many diabetic patients on hemodialysis in comparison to reference values for iPTH patients on dialysis with stage 5 CKD, according to USA National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI). There is a discretely negative correlation between serum magnesium and iPTH, indicative of a suppressive effect of hypermagnesaemia on the synthesis and/or secretion of the parathyroid hormone.