# hs-cTnT-niveaus wijzen op risico acute nierinsufficiëntie in de spoedeisende hulp

*geplaatst 2026-10-06 · Nierziekte · Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals · doi 10.1080/1354750X.2026.2742157 · https://hartvaat.nl/2026/09/29/hs-ctnt-niveaus-wijzen-op-risico-acute-nierinsufficientie-in-de-spoedeisende-hul/*

Een cohortstudie van 23.292 spoedeisende hulp-consulten onderzocht de associatie tussen hs-cTnT en het ontstaan van acute nierinsufficiëntie (ANI). Patiënten met een verhoogd hs-cTnT hadden een significant hoger risico op ANI binnen 48 uur (gecorrigeerde OR 1,58 per eenheid ln-hs-cTnT). Een drempelwaarde van 148 ng/L gaf een negatieve voorspellende waarde van 97%. Dit suggereert dat hs-cTnT, naast zijn cardiale waarde, nuttig kan zijn om patiënten in de spoedeisende hulp te identificeren die extra monitoring van de nierfunctie nodig hebben.

## English: High-Sensitivity Cardiac Troponin T is Associated with Acute Kidney Injury in Emergency Department Patients.

An observational study of 23,292 emergency department encounters evaluated whether high-sensitivity cardiac troponin T (hs-cTnT) predicts subsequent acute kidney injury (AKI). Elevated hs-cTnT was independently associated with AKI within 48 hours (adjusted OR 1.58 per 1-unit increase in ln[hs-cTnT]), with a cutoff of 148 ng/L demonstrating 80% sensitivity and a 97% negative predictive value. These findings suggest that hs-cTnT could serve as a practical biomarker to identify ED patients at risk for AKI, warranting closer renal function monitoring regardless of baseline kidney status.

## Abstract (original, from the publication)

INTRODUCTION: Chronic high-sensitivity cardiac troponin T (hs-cTnT) elevations are common in chronic kidney disease, but whether hs-cTnT predicts subsequent acute kidney injury (AKI) is unclear. METHODS: We examined the association between maximum hs-cTnT and subsequent AKI in 23,292 Emergency Department encounters. AKI was defined as serum creatinine (sCr) increase ≥0.3 mg/dL within 48 hours or ≥1.5x the presenting value; secondary endpoints were time to AKI and peak sCr. RESULTS: AKI occurred in 8.9% of encounters. Maximum hs-cTnT was independently associated with AKI (adjusted OR 1.58 [95% CI 1.53-1.63] per 1-unit increase in ln[hs-cTnT]), with similar associations among encounters with and without reduced kidney function at presentation. The median interval from maximum hs-cTnT to AKI was 43 hours (IQR, 21-97). A data-derived hs-cTnT cutoff of 148 ng/L yielded an AUC of 0.82, 80% sensitivity, 70% specificity, and 97% negative predictive value for AKI. Among encounters with AKI, maximum ln(hs-cTnT) was modestly associated with ln(sCr) at AKI in univariable analysis (R2=0.10) and with subsequent maximum ln(sCr) after multivariable adjustment (incremental R2=0.04; both P < 0.0001). CONCLUSION: Maximum hs-cTnT identified patients at increased risk for subsequent AKI, including those with normal renal function at presentation, and may help identify patients warranting closer kidney-function monitoring.

Auteurs: Megan Woelkers, Sutton Fox, Davis C Murray, Saiharinath Nerella, Elizabeth Tabornal, Nicholas Bevins, Robert Fitzgerald, Lori B Daniels

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Bron: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals, https://doi.org/10.1080/1354750X.2026.2742157. Bijgewerkt 2026-09-30T00:58:06Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.