Influence of renal function on serum and urinary heart fatty acid-binding protein levels

• Published in: Journal of cardiovascular surgery Vol. 42; no. 6; pp. 735 - 740
• Main Authors: Nayashida, N, Chihara, S, Tayama, E, Akasu, K, Kai, E, Kawara, T, Aoyagi, S
• Format: Journal Article
• Language: English
• Published: Italy Edizioni Minerva Medica 01.12.2001
• Subjects: Aged; Biomarkers - blood; Biomarkers - urine; Carrier Proteins - blood; Carrier Proteins - urine; Case-Control Studies; Coronary Artery Bypass; Creatine Kinase - blood; Creatine Kinase, MB Form; Creatinine - blood; Fatty Acid-Binding Protein 7; Fatty Acid-Binding Proteins; Fatty Acids - blood; Fatty Acids - urine; Female; Humans; Intraoperative Care; Isoenzymes - blood; Kidney Diseases - blood; Kidney Diseases - physiopathology; Kidney Diseases - urine; Kidney Function Tests; Male; Middle Aged; Neoplasm Proteins; Prospective Studies; Troponin T - blood; Tumor Suppressor Proteins
• ISSN: 0021-9509; 1827-191X

Serum heart fatty acid-binding protein (H-FABP) has been reported to be a sensitive and early indicator of myocardial damage. However, circulating H-FABP may be cleared considerably from kidney, similar to that found for myoglobin. Therefore, the possibility exists that any change in renal function affects serum H-FABP concentration, and thus leads to erroneous interpretation. To evaluate the influence of renal function on H-FABP levels, we conducted a prospective study. Nineteen patients undergoing isolated primary coronary artery bypass grafting were enrolled in this study. The patients were classified by the preoperative creatinine clearance into two groups: the control group (n=12); patients with creatinine clearance of 40 mL/min or greater, and the renal dysfunction group (n=7); patients with creatinine clearance of less than 40 mL/min. Serum H-FABP, CK-MB, troponin-T and urinary H-FABP levels were measured perioperatively. None of the patients had perioperative myocardial infarction. No significant differences were found in CK-MB and troponin-T levels between the groups. The renal dysfunction group resulted in significantly (p<0.05) higher serum H-FABP levels and lower urinary H-FABP levels than those in the control group, postoperatively. The creatinine clearance correlated inversely with the peak levels of serum H-FABP (r=-0.75, p=0.0001) and correlated with the peak levels of urinary H-FABP (r=0.64, p=0.003). The results indicate that the kidneys play an important role in the clearance of serum H-FABP. Thus, caution must be taken in interpreting this marker for myocardial damage during cardiac surgery in patients with renal dysfunction.