{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:21:36Z","timestamp":1769109696261,"version":"3.49.0"},"reference-count":66,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Changes in high sensitivity cardiac troponin-T (hs-cTnT) concentrations may reflect either acute myocardial injury or biological variation. Distinguishing between these entities is essential to accurate diagnosis, however, the biological variation of hs-cTnT in dialysis population is currently unknown. We sought to estimate the within- and between-person coefficients of variation of hs-cTnT in stable dialysis patients, and derive the critical difference between measurements needed to exclude biological variation with 99% confidence.<\/jats:p><jats:p>Fifty-five prevalent haemo- and peritoneal-dialysis patients attending two metropolitan hospitals were assessed on 10 consecutive occasions; weekly for 5 weeks then monthly for 4 months. Assessments were conducted at the same dialysis cycle time-point and entailed hs-cTnT testing, clinical review, electrocardiography, and bioimpedance spectroscopy. Patients were excluded if they developed clinical or physiological instability.<\/jats:p><jats:p>In total 137 weekly and 114 monthly hs-cTnT measurements from 42 stable patients were analysed. Respective between- and within-person coefficients of variation were 83% and 7.9% for weekly measurements, and 79% and 12.6% for monthly measurements. Within-person variation was unaffected by dialysis modality or cardiac co-morbidity. The bidirectional 99% reference change value was \u201325% and +33% for weekly measurements, and \u201337% and +58% for monthly measurements.<\/jats:p><jats:p>The between-person variation of hs-cTnT in the dialysis population is markedly greater than within-person variation indicating that hs-cTnT testing is best applied in this population using a relative change strategy. An increase of 33% or a reduction of 25% in serial hs-cTnT concentrations measured at weekly intervals excludes change due to analytical and biological variation alone with 99% confidence.<\/jats:p>","DOI":"10.1515\/cclm-2014-0838","type":"journal-article","created":{"date-parts":[[2015,4,11]],"date-time":"2015-04-11T01:57:05Z","timestamp":1428717425000},"source":"Crossref","is-referenced-by-count":20,"title":["Biological variation of high sensitivity cardiac troponin-T in stable dialysis patients: implications for clinical practice"],"prefix":"10.1515","volume":"53","author":[{"given":"Magid A.","family":"Fahim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Hayen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea R.","family":"Horvath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goce","family":"Dimeski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Coburn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken-Soon","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan C.","family":"Craig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott B.","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmel M.","family":"Hawley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref571","first-page":"99","article-title":"de CM Preanalytical storage does not affect th percentile cardiac troponin T concentrations measured with a high - sensitivity assay","author":"Gillis","year":"2013","journal-title":"Clin Chem"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1373\/clinchem.2009.134460","article-title":"High - sensitivity cardiac troponin T for early prediction of evolving non - ST - segment elevation myocardial infarction in patients with suspected acute coronary syndrome and negative troponin results on admission","author":"Giannitsis","year":"2010","journal-title":"Clin Chem"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1111\/j.1523-1755.2004.00657.x","article-title":"Cardiac diseases in maintenance hemodialysis patients : results of the HEMO Study","author":"Cheung","year":"2004","journal-title":"Kidney Int"},{"key":"ref541","doi-asserted-by":"crossref","DOI":"10.1016\/0735-1097(93)90455-A","article-title":"The epidemiology of heart failure the Study","volume":"22","author":"Ho","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"ref521","first-page":"132","article-title":"Influence of sampling time and ultrafiltration coefficient of the dialysis membrane on cardiac troponin","author":"Lippi","year":"2008","journal-title":"Arch Pathol Lab Med"},{"key":"ref601","doi-asserted-by":"crossref","DOI":"10.1373\/clinchem.2006.069369","article-title":"Reference change values for brain natriuretic peptides revisited","author":"Fokkema","year":"2006","journal-title":"Clin Chem"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1111\/j.1523-1755.2004.00657.x","article-title":"Cardiac diseases in maintenance hemodialysis patients : results of the HEMO Study","author":"Cheung","year":"2004","journal-title":"Kidney Int"},{"key":"ref381","article-title":"US Renal Data System annual data report : atlas of chronic kidney disease and end - stage renal disease in the United States National Institutes of National Institutes of Diabetes and Digestive and Kidney Diseases MD","author":"USRDS","year":"2012","journal-title":"Health"},{"key":"ref591","first-page":"289","article-title":"Burden of systolic and diastolic ventricular dysfunction in the community : appreciating the scope of the heart failure epidemic","author":"Redfield","year":"2003","journal-title":"Am Med Assoc"},{"key":"ref221","article-title":"PH Confidence intervals and power calculations for within - person biological variation : effect of analytical imprecision number of replicates number of samples and number of individuals","volume":"13","author":"Roraas","year":"2012","journal-title":"Clin Chem"},{"key":"ref61","first-page":"53","article-title":"Group National Academy of Clinical Biochemistry laboratory medicine practice guidelines : use of cardiac troponin and type natriuretic peptide or terminal proB - type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure","author":"Wu","year":"2007","journal-title":"Clin Chem"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1373\/clinchem.2009.134460","article-title":"High - sensitivity cardiac troponin T for early prediction of evolving non - ST - segment elevation myocardial infarction in patients with suspected acute coronary syndrome and negative troponin results on admission","author":"Giannitsis","year":"2010","journal-title":"Clin Chem"},{"key":"ref421","first-page":"53","article-title":"Group National Academy of Clinical Biochemistry laboratory medicine practice guidelines : use of cardiac troponin and type natriuretic peptide or terminal proB - type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure","author":"Wu","year":"2007","journal-title":"Clin Chem"},{"key":"ref411","first-page":"126","article-title":"AS HD Third universal definition of myocardial infarction","author":"Thygesen","year":"2012","journal-title":"Circulation"},{"key":"ref581","article-title":"PH Confidence intervals and power calculations for within - person biological variation : effect of analytical imprecision number of replicates number of samples and number of individuals","volume":"13","author":"Roraas","year":"2012","journal-title":"Clin Chem"},{"key":"ref661","first-page":"59","article-title":"AS Short - and long - term individual variation in cardiac troponin in patients with stable coronary artery disease","author":"Nordenskjold","year":"2013","journal-title":"AM Clin Chem"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1161\/circ.54.3.947585","article-title":"Letter grading of angina pectoris","author":"Campeau","year":"1976","journal-title":"Circulation"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3109\/10408368909106595","article-title":"Generation and application of data on biological variation in clinical chemistry","volume":"27","author":"Fraser","year":"1989","journal-title":"Crit Rev Clin Lab Sci"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/j.1440-1797.2011.01486.x","article-title":"Morbidity burden of end - stage kidney disease in Australia : hospital separation rates among people receiving kidney replacement therapy","volume":"16","author":"McDonald","year":"2011","journal-title":"Nephrology"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.clinbiochem.2009.03.027","article-title":"Intra - 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and long - term individual variation in cardiac troponin in patients with stable coronary artery disease","author":"Nordenskjold","year":"2013","journal-title":"AM Clin Chem"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/0736-4679(91)90320-F","article-title":"Emergency department presentation of renal dialysis patients : indications for EMS transport directly to dialysis centers","author":"Sacchetti","year":"1991","journal-title":"J Emerg Med"},{"key":"ref101","first-page":"412","article-title":"Multicenter analytical evaluation of a high - sensitivity troponin assay","author":"Saenger","year":"2011","journal-title":"Clin Chim Acta"},{"key":"ref91","first-page":"120","article-title":"Classifying laboratory incident reports to identify problems that jeopardize patient safety","author":"Astion","year":"2003","journal-title":"Am J Clin Pathol"},{"key":"ref211","first-page":"99","article-title":"de CM Preanalytical storage does not affect th percentile cardiac troponin T concentrations measured with a high - sensitivity assay","author":"Gillis","year":"2013","journal-title":"Clin Chem"},{"key":"ref701","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1681\/ASN.2007111188","article-title":"Relationship between dialysis modality mortality","volume":"20","author":"McDonald","year":"2009","journal-title":"J Am Soc Nephrol"},{"key":"ref271","first-page":"87","article-title":"EH Significance of acute versus chronic troponin elevation in dialysis patients","author":"Klootwijk","year":"2004","journal-title":"Nephron Clin Pract"},{"key":"ref631","first-page":"87","article-title":"EH Significance of acute versus chronic troponin elevation in dialysis patients","author":"Klootwijk","year":"2004","journal-title":"Nephron Clin Pract"},{"key":"ref51","first-page":"126","article-title":"AS HD Third universal definition of myocardial infarction","author":"Thygesen","year":"2012","journal-title":"Circulation"},{"key":"ref651","first-page":"71","article-title":"Frankenstein Biological variation and reference change value of high - sensitivity troponin T in healthy individuals during short and intermediate follow - up periods","author":"Wu","year":"2011","journal-title":"Clin Chem"},{"key":"ref241","doi-asserted-by":"crossref","DOI":"10.1373\/clinchem.2006.069369","article-title":"Reference change values for brain natriuretic peptides revisited","author":"Fokkema","year":"2006","journal-title":"Clin Chem"},{"key":"ref451","first-page":"120","article-title":"Classifying laboratory incident reports to identify problems that jeopardize patient safety","author":"Astion","year":"2003","journal-title":"Am J Clin Pathol"},{"key":"ref261","first-page":"413","article-title":"Serial cardiac troponin differences measured on four contemporary analyzers : relative differences actual differences and reference change values compared","author":"Pretorius","year":"2012","journal-title":"Clin Chim Acta"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1161\/circ.54.3.947585","article-title":"Letter grading of angina pectoris","author":"Campeau","year":"1976","journal-title":"Circulation"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.jacc.2010.11.066","article-title":"AT TA MS GD RE Myocardial ischemia induced by rapid atrial pacing causes troponin T release detectable by a highly sensitive assay : insights from a coronary sinus sampling study","author":"Turer","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/j.1440-1797.2012.01625.x","article-title":"Cardiac high - sensitivity troponin measurement a layer of complexity in managing haemodialysis patients","volume":"17","author":"Pianta","year":"2012","journal-title":"Nephrology"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.clinbiochem.2009.03.027","article-title":"Intra - individual variability in troponin concentration in dialysis patients","author":"Hill","year":"2009","journal-title":"Clin Biochem"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/0736-4679(91)90320-F","article-title":"Emergency department presentation of renal dialysis patients : indications for EMS transport directly to dialysis centers","author":"Sacchetti","year":"1991","journal-title":"J Emerg Med"},{"key":"ref181","doi-asserted-by":"crossref","DOI":"10.1016\/0735-1097(93)90455-A","article-title":"The epidemiology of heart failure the Study","volume":"22","author":"Ho","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.jacc.2010.11.066","article-title":"AT TA MS GD RE Myocardial ischemia induced by rapid atrial pacing causes troponin T release detectable by a highly sensitive assay : insights from a coronary sinus sampling study","author":"Turer","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"ref621","first-page":"413","article-title":"Serial cardiac troponin differences measured on four contemporary analyzers : relative differences actual differences and reference change values compared","author":"Pretorius","year":"2012","journal-title":"Clin Chim Acta"}],"container-title":["Clinical Chemistry and Laboratory Medicine (CCLM)"],"original-title":[],"link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2014-0838\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T23:46:41Z","timestamp":1619048801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2014-0838\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,1]]},"references-count":66,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1515\/cclm-2014-0838","relation":{},"ISSN":["1437-4331","1434-6621"],"issn-type":[{"value":"1437-4331","type":"electronic"},{"value":"1434-6621","type":"print"}],"subject":[],"published":{"date-parts":[[2015,1,1]]}}}