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Blood tests identify patients on dialysis at high risk for death from cardiovascular disease

Routine blood tests given to people suspected of having a heart attack can also reliably measure the risk of heart disease in people on dialysis awaiting a kidney transplant, even though they have no symptoms of heart disease. That's according to a team of researchers led by a University of Maryland cardiologist. Their study is published in the July 16, 2003 issue of the Journal of the American Medical Association.

The tests, which measure troponin T and C-reactive protein, appear to detect silent, small heart attacks and coronary artery disease. The results may make it possible, for the first time, for doctors to gauge the risk of heart disease in patients on dialysis who do not have cardiac symptoms, and determine which patients need additional treatment to address their underlying cardiovascular disease.

Despite advances in dialysis, death rates of people with end stage renal disease remain as high as 23 percent each year, with cardiovascular problems causing nearly 45 percent of all deaths. Cardiac events continue to take their toll even after kidney transplantation, accounting for half the deaths in the first 30 days following transplant, mainly from heart attack.

"This could be a simple, cost-effective way to screen the nearly 300,000 people on dialysis in the United States, a high risk group that has been difficult to test for heart disease in the past," says lead author, Christopher deFilippi, M.D., a cardiologist at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. "Those found to have these cardiac risk factors may need further tests or interventions such as bypass surgery before undergoing a kidney transplant, for the best outcome," says deFilippi.

The study of 224 patients with end stage renal disease was initiated in 1998 at five hemodialysis centers in the Houston-Galveston region of Texas. Patients in the study were on kidney dial
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Contact: Bill Seiler
bseiler@pipeline.com
410-328-8919
University of Maryland Medical Center
15-Jul-2003


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