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In recent years, biomarkers such as cardiac troponins have become indispensable to the diagnosis and prognosis of cardiac disease, such as MI and heart failure. However, these biomarkers behave differently in the general population compared with people with kidney disease, who may have higher baseline levels and reactions to acute disturbance due to a combination of reduced renal clearance of biomarker molecules and increased production due to concurrent cardiovascular disease and cardiorenal syndrome. Three decades of research into cardiac biomarkers have produced a range of literature investigating their applications in different patient groups and healthcare settings. This review explores the evidence surrounding measurement and interpretation of cardiac troponin levels in people who have chronic kidney disease, and have had dialysis and\/or kidney transplantation, with reference to baseline levels and changes over time, their relationship to incident cardiovascular morbidity and mortality, and their application in acute settings.<\/jats:p>","DOI":"10.15420\/ecr.2024.51","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T10:35:18Z","timestamp":1755167718000},"source":"Crossref","is-referenced-by-count":6,"title":["Cardiac Troponins in Kidney Disease"],"prefix":"10.15420","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0896-646X","authenticated-orcid":false,"given":"Daniel","family":"Murphy","sequence":"first","affiliation":[{"name":"Renal and Transplantation Unit, St George\u2019s University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-2325","authenticated-orcid":false,"given":"Debasish","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Renal and Transplantation Unit, St George\u2019s University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Banerjee D, Perrett C, Banerjee A. Troponins, acute coronary syndrome and renal disease: from acute kidney injury through end-stage kidney disease. Eur Cardiol 2019;14:187\u201390. https:\/\/doi.org\/10.15420\/ecr.2019.28.2; PMID:\u00a031933690.","DOI":"10.15420\/ecr.2019.28.2"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"deFilippi C, Seliger S. The cardiac troponin renal disease diagnostic conundrum: past, present, and future. Circulation 2018;137:452\u20134. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.117.031717; PMID:\u00a029378755.","DOI":"10.1161\/circulationaha.117.031717"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Stevens PE, O\u2019Donoghue DJ, de Lusignan S, et al. Chronic kidney disease management in the United Kingdom: NEOERICA project results. Kidney Int 2007;72:92\u20139. https:\/\/doi.org\/10.1038\/sj.ki.5002273; PMID:\u00a017440495.","DOI":"10.1038\/sj.ki.5002273"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Chronic Kidney Disease Prognosis Consortium. 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Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the Chronic Renal Insufficiency Cohort (CRIC). BMC Nephrol 2013;14:229. https:\/\/doi.org\/10.1186\/1471-2369-14-229; PMID:\u00a024148285.","DOI":"10.1186\/1471-2369-14-229"},{"key":"ref23","unstructured":"Chesnaye NC, Szummer K, B\u00e1r\u00e1ny P, et al. Association between renal function and troponin T over time in stable chronic kidney disease patients. J Am Heart Assoc 2019;8:e013091. https:\/\/doi.org\/10.1161\/JAHA.119.013091; PMID:\u00a031662068."},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Snaedal S, B\u00e1r\u00e1ny P, Lund SH, et al. High-sensitivity troponins in dialysis patients: variation and prognostic value. Clin Kidney J 2021;14:1789\u201397. https:\/\/doi.org\/10.1093\/ckj\/sfaa215; PMID:\u00a034221386.","DOI":"10.1093\/ckj\/sfaa215"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Eriguchi M, Tsuruya K, Lopes M, et al. 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High sensitivity troponin-I levels in asymptomatic hemodialysis patients. Ren Fail 2019;41:393\u2013400. https:\/\/doi.org\/10.1080\/0886022X.2019.1603110; PMID:\u00a031132904.","DOI":"10.1080\/0886022x.2019.1603110"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Hill SA, Cleve R, Carlisle E, et al. Intra-individual variability in troponin T concentration in dialysis patients. Clin Biochem 2009;42:991\u20135. https:\/\/doi.org\/10.1016\/j.clinbiochem.2009.03.027; PMID:\u00a019362083.","DOI":"10.1016\/j.clinbiochem.2009.03.027"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Ortega O, Rodriguez I, Gracia C, et al. Strict volume control and longitudinal changes in cardiac biomarker levels in hemodialysis patients. Nephron Clin Pract 2009;113:c96\u2013103. https:\/\/doi.org\/10.1159\/000228541; PMID:\u00a019602905.","DOI":"10.1159\/000228541"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Wayand D, Baum H, Sch\u00e4tzle G, et al. 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B-type natriuretic peptide and cardiac troponin I are associated with adverse outcomes in stable kidney transplant recipients. Transplantation 2017;101:182\u201390. https:\/\/doi.org\/10.1097\/TP.0000000000001080; PMID:\u00a026910333.","DOI":"10.1097\/TP.0000000000001080"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Connolly GM, Cunningham R, McNamee PT, et al. Troponin T is an independent predictor of mortality in renal transplant recipients. Nephrol Dial Transplant 2008;23:1019\u201325. https:\/\/doi.org\/10.1093\/ndt\/gfm738; PMID:\u00a018065785.","DOI":"10.1093\/ndt\/gfm738"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Lamb EJ, Kenny C, Abbas NA, et al. Cardiac troponin I concentration is commonly increased in nondialysis patients with CKD: experience with a sensitive assay. 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