Authors' objectives: To systematically review the literature on the use of cardiac troponin levels in patients with chronic kidney disease (CKD) regarding four Key Questions (KQ): (1) diagnosis of acute coronary syndrome (ACS), (2) management decisions for ACS, (3) prognosis after presenting with ACS, and (4) risk stratification in patients without symptoms of ACS.

Authors' recommendations: Cardiac troponin elevations are associated with a worse prognosis for CKD patients with and without suspected ACS. However, the wide variation in assays and cutoffs, along with the lack of comparative studies, prevents clear conclusions about how this association should change management, compared with management based on clinical factors or evidence derived from the non-CKD population. Future research should compare various management strategies that incorporate measuring cardiac troponins in their algorithms, including using different cutoffs or assays. For this research to be effective, troponin assays and cutpoints need to be standardized and harmonized so that results can be pooled, compared, and applied in practice.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.effectivehealthcare.ahrq.gov/ehc/products/431/1949/renal-function-report-140812.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)