Association of Cardiac Biomarkers of Heart Failure and Iron Status in Hemodialysis Patients

Study Population and Data Source

This is a cross-sectional, single-center study which will be conducted in the Dialysis Center of Tungs' Taichung MetroHarbor Hospital (TTMHH) in the coastal region of central Taiwan. A cohort of 500 patients aged 20 or over, who have been on HD for at least 3 months prior to enrollment will be included. The medical charts of these patients are reviewed for eligibility identification, and should be compatible with the inclusion/exclusion criteria and enrolled in our analysis. The research was conducted ethically in accordance to the World Medical Association Declaration of Helsinki. Subjects provided written informed consent and the Local Ethical Committee approved the study.

The baseline data such as demographics, comorbidities, anthropometrics, and relevant laboratory data, clinical diagnosis of hear failure based on cardiac echocardiograhy measurements, and medication history will be collected. None of the patients were receiving blood transfusions, or intravenous iron therapy within two weeks before the time of inclusion. Doppler echocardiography using standardized equipment and complying with recommendations from the American Society of Echocardiography (2009)[20]. The biplane method of disks was used to measure left ventricular (LV) EF. Patients were eligible for the study if they had the New York Heart Association (NYHA) functional class II-IV; HFrEF and left ventricular EF (LVEF)≤40%. The characteristics of patients will be exclude from our study were (1) decompensated cirrhosis , (2) neoplastic diseases , (3) incomplete data, (4) receiving hemodialysis < 3 months and active infection.

Iron Status and Other Laboratory Measurements

Blood was drawn with EDTA anticoagulant in the morning after an overnight fast of at least 12 h before a dialysis session. The samples were separated via centrifugation (3000 rpm, 10 min) and immediately stored at -80°C for subsequent assays. Glucose, high-density lipoprotein cholesterol HDL), triglycerides and total cholesterol are all measured by standard assays using the analyzer. Low-density lipoprotein cholesterol (LDL) is measured by standard assay. High-sensitivity C-reactive protein (hsCRP) and are measured using standard nephelometry. Serum hs-cTnT was measured using a sandwich immunoassay method, a novel highly sensitive assay with a lower measurable limit of 3 ng/L.