| dc.description.abstract | End-Stage Kidney Disease (ESKD) is the terminal stage of chronic kidney disease (CKD) characterized by irreversible loss of kidney function requiring renal replacement therapy such as hemodialysis or kidney transplantation. Globally, CKD affects approximately 10% of the population, representing over 800 million individuals, with an estimated prevalence of 14% in sub-Saharan Africa and approximately 4% in Kenya. Cardiovascular complications remain the leading cause of morbidity and mortality among patients with ESKD. Cardiac Troponin T (cTnT), a sensitive biomarker of myocardial injury, is frequently elevated in ESKD patients; however, its relationship with renal biochemical parameters and associated risk factors remains poorly understood in resource-limited settings such as Western Kenya. The broad objective of this study was to determine the association between renal biochemical parameters, risk factors, and cardiac Troponin T levels among ESKD patients undergoing hemodialysis at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Western Kenya. Specifically, the study assessed the association between demographic characteristics and renal biochemical parameters, established the relationship between renal biochemical parameters and cTnT levels, and evaluated risk factors associated with elevated cTnT levels. A cross-sectional descriptive study design was employed involving 71 ESKD patients selected through purposive sampling. Cardiac Troponin T levels were analyzed using Roche Cobas immunoassay analyzers, while renal biochemical parameters were measured using a Mindray chemistry analyzer with an ISE module. Descriptive statistics were used to summarize demographic and clinical characteristics, while Chi-square tests, Fisher’s exact tests, and ordinal regression analyses were used to assess associations between variables at a significance level of p < 0.05. Ethical approval was obtained from the Institutional Scientific and Ethics Review Committee (ISERC) of JOOTRH and research authorization granted by NACOSTI. Among the participants, 50.7% were female and 49.3% were male. Elevated cTnT levels were observed in 98.6% of the participants. Age was not significantly associated with renal biochemical parameters (p > 0.05). However, gender demonstrated a statistically significant association with phosphorus levels (OR = 0.33, 95% CI: 0.11–0.98, p = 0.042). No statistically significant associations were observed between cTnT levels and creatinine (p = 1.000), urea (p = 1.000), sodium (p = 0.410), potassium (p = 1.000), calcium (p = 1.000), or phosphorus levels (p = 1.000). Chloride levels, however, showed a statistically significant association with cTnT levels (p < 0.001). Among the evaluated risk factors, frequency of dialysis sessions per week was significantly associated with elevated cTnT levels (OR = 6.36, 95% CI: 3.69–10.95, p = 0.026), while other comorbidities including hypertension, diabetes mellitus, HIV, cancer, and arthritis were not statistically significant. Elevated cTnT levels in ESKD, may be due to impaired renal function rather than an acute myocardial event, and clinicians should not automatically assume myocardial infarction based solely on troponin levels. This study reveals that gender has a noteworthy impact, specifically on phosphorus levels, indicating that men may be less likely to have elevated phosphorus compared to women. The significant finding with chloride underscores the importance of electrolyte management in ESKD patients and cardiovascular risk, and the potential benefits of increasing dialysis frequency to improve health outcomes. The study suggests the explore dynamics in elevated phosphorus level and gender specifically female to enhance understanding of the interplay between gender, phosphorous and cardiac health. Measure of chloride levels in CKD patients as a predictor of heart health. Future research focusing on the number of dialysis sessions to cardiovascular health outcomes in end-stage kidney disease (ESKD) patients. | en_US |
