Cardiac Biomarkers and Health-Related Quality of Life in New Hemodialysis Patients without Symptomatic Cardiac Disease

Abstract

Background: Health Related Quality of Life (HRQOL) is impaired in hemodialysis patients and cardiac biomarkers are elevated, but their relationship is uncertain. Objectives: To determine whether the cardiac biomarkers, troponin T and N terminal pro-B type natriuretic peptide (NT-proBNP), predict deterioration in the physical domains of HRQOL. Design: A prospective cohort study of patients in a randomized controlled clinical trial of correction of anemia with erythropoietin. Setting: Multiple hemodialysis centers located throughout Canada and Europe. Participants: Patients who started maintenance hemodialysis within the previous 3–18 months, with no clinical evidence or prior history of symptomatic cardiac failure or ischemic heart disease, and left ventricular volume 0.05 ng/mL were significantly associated with the change from baseline to 96 weeks follow-up for SF-36 vitality and FACIT-fatigue scores, and approached statistical significance for SF-36 physical function (0.056). Limitations: Not possible to confirm whether Troponin T associations were independent of subsequent cardiac events. Conclusions: In hemodialysis patients without prior symptomatic cardiac disease and without a dilated left ventricle at baseline, elevated baseline Troponin T levels, but not NT-pro BNP, were independently associated with deterioration in the physical domains of HRQOL.