Troponina T ultrasensible y CA125 como marcadores pronósticos en pacientes con enfermedad renal terminal en hemodiálisis
Palabras clave:
Diálisis Renal, Marcadores Biológicos, Troponina T, Antígeno Ca-125, Síndrome Coronario AgudoResumen
Introducción: Los pacientes con enfermedad renal terminal (ERT) en hemodiálisis (HD) tienen una alta morbimortalidad, principalmente debido a enfermedades cardiovasculares (CV). Los biomarcadores, como la troponina T ultrasensible (TnTUS) y el antígeno carbohidrato 125 (CA125), sirven para establecer pronóstico CV y tratar adecuadamente y de manera preventiva a los pacientes con un riesgo más elevado.
Materiales y Métodos: Se incluyeron pacientes con ERT y al menos tres meses de HD, midiendo en una muestra de plasma los marcadores TnTUS y CA125. Aquellos con evidencia clínica de estar cursando un síndrome coronario agudo fueron excluidos. Se realizó seguimiento por 12 meses donde se valoraron los eventos CV y las hospitalizaciones por cualquier causa.
Resultados: Se incluyeron 87 pacientes de 58±15 años, 76% de sexo masculino. La mediana de TnTUS basal fue de 49 ng/l (15,3 – 214,1) encontrándose elevada en 95,4% de los pacientes. La mediana de CA125 fue 13,7 U/ml (6,1 – 52,7). Los pacientes que presentaron una MACE, tenían valores más elevados de CA125 (p<0,03) y TnTUS (p<0,001), y todos ellos presentaban un valor de TnTUS ? 69,37 ng/l.
Conclusión: Los pacientes con ERT en HD tienen una prevalencia de niveles elevados de TnTUS de 95,4% y de CA125 de 10%. Los pacientes con MACE tuvieron significativamente valores más elevados de ambos marcadores, pudiendo determinar que poseen valor pronóstico en este grupo de pacientes.Descargas
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