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Peer-reviewedCC BY-NC-ND 4.0Seminars in Dialysis

The Intradialytic Changes in Cardiac Troponin I—A Systematic Review

  • Johan Ferrier Jørgensen1
  • Frans Brandt2,3
  • Michael Waldhauer Hunderup4
  • Jan Dominik Kampmann2,3
4 affiliations
  1. 1Department of Radiology Kolding, Sygehus Lillebælt Kolding Denmark
  2. 2Internal Medicine Research Unit University Hospital of Southern Denmark Aabenraa Denmark
  3. 3Department of Regional Health Research University of Southern Denmark Odense Denmark
  4. 4Department of Clinical Biochemistry Odense University Hospital Odense Denmark
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Abstract

Cardiovascular disease is the leading cause of death in patients receiving hemodialysis. Current guidelines define acute myocardial infarction (AMI) by troponin levels above the 99th percentile, accompanied by a ≥ 20% rise or fall. However, troponin concentrations are often elevated, and hemodialysis may influence troponin levels during treatment. This systematic review aims to evaluate whether these factors compromise the diagnostic accuracy of troponin for AMI in patients undergoing hemodialysis. We performed a systematic review including 6359 studies. Inclusion criteria were adult patients and studies reporting predialysis and postdialysis assessment of troponin I. Twenty‐eight studies were deemed suitable. Mean troponin I was assessed before and after dialysis. The risk of bias and applicability of the included studies were assessed. The studies were heterogeneous in terms of reporting intradialytic changes of troponin, either in mean or median, which was a problem, along with the lack of reporting dialysis details. The mean troponin predialysis was 68 ng/L, and the mean troponin postdialysis was 73 ng/L. The troponin changes during dialysis were between −100% and +933%. The per se elevated troponin I and the unpredictable changes during dialysis make the use of the current AMI guidelines challenging for patients on dialysis.

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Cite

BibTeXRIS
BibTeX
@article{jorgensen2026intradialytic,
  title = {{The Intradialytic Changes in Cardiac Troponin I—A Systematic Review}},
  author = {Johan Ferrier Jørgensen and Frans Brandt and Michael Waldhauer Hunderup and Jan Dominik Kampmann},
  journal = {Seminars in Dialysis},
  year = {2026},
  month = oct,
  doi = {10.1111/sdi.70049},
  url = {https://doi.org/10.1111/sdi.70049},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - The Intradialytic Changes in Cardiac Troponin I—A Systematic Review
AU  - Johan Ferrier Jørgensen
AU  - Frans Brandt
AU  - Michael Waldhauer Hunderup
AU  - Jan Dominik Kampmann
PY  - 2026
DA  - 2026/10/01
JO  - Seminars in Dialysis
DO  - 10.1111/sdi.70049
UR  - https://doi.org/10.1111/sdi.70049
AB  - Cardiovascular disease is the leading cause of death in patients receiving hemodialysis. Current guidelines define acute myocardial infarction (AMI) by troponin levels above the 99th percentile, accompanied by a ≥ 20% rise or fall. However, troponin concentrations are often elevated, and hemodialysis may influence troponin levels during treatment. This systematic review aims to evaluate whether these factors compromise the diagnostic accuracy of troponin for AMI in patients undergoing hemodialysis. We performed a systematic review including 6359 studies. Inclusion criteria were adult patients and studies reporting predialysis and postdialysis assessment of troponin I. Twenty‐eight studies were deemed suitable. Mean troponin I was assessed before and after dialysis. The risk of bias and applicability of the included studies were assessed. The studies were heterogeneous in terms of reporting intradialytic changes of troponin, either in mean or median, which was a problem, along with the lack of reporting dialysis details. The mean troponin predialysis was 68 ng/L, and the mean troponin postdialysis was 73 ng/L. The troponin changes during dialysis were between −100% and +933%. The per se elevated troponin I and the unpredictable changes during dialysis make the use of the current AMI guidelines challenging for patients on dialysis.
SN  - 0894-0959
SN  - 1525-139X
ER  -