SciELO - Scientific Electronic Library Online

vol.7 issue2Prevalence and factors associated with anxiety in patients with chronic kidney disease in two dialysis units in BoyacáPrevalence of chronic kidney disease in a population with type 2 diabetes of a cardiovascular risk program author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Revista Colombiana de Nefrología

On-line version ISSN 2500-5006

Rev. colom. nefrol. vol.7 no.2 Bogotá July/Dec. 2020  Epub Apr 23, 2021 

Artículo de investigación original

Kidney disease and hemodialysis: identification of blood biomarkers to detect heart failure and kidney failure

Enfermedad renal y hemodiálisis: identificación de biomarcadores sanguíneos para detectar insuficiencia cardíaca e insuficiencia renal

Barbara Leticia Dudel Mayer1  *

Pollyana Thays Lameira da Costa1

Maria Elena Echevarría-Guanilo1

Silvana Silveira Kempfer1

Kleber Maciel da Silva Pieri2

1 Graduate Nursing Program, Department of Nursing, Federal University of Santa Catarina, Florianópolis, Brazil.

2 Clinical Analysis Laboratory, University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil.



to identify valid blood biomarkers to detect heart failure and kidney failure associated with kidney disease and hemodialysis


systematic literature review conducted in August 2018 in the following: Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct and Lilacs. The guiding question was: "What are the blood biomarkers used to detect heart failure and kidney failure?" A total of537 publications were found, 94 of these appeared more than once, 383 were excluded after reading titles and abstracts, 32 were excluded after reading the full texts, and 10 were excluded in the quantitative and qualitative synthesis.


18 papers compose the final sample and report laboratory and imaging tests, instruments to assess the risk of kidney and heart failure, and also clinical management of the progression of kidney and heart failure. All the studies correlated risk of mortality and death outcome.


laboratory tests are important to identifying kidney and heart failure and need to be used to improve clinical management of the hemodialysis treatment of people with chronic kidney disease in order to improve quality of life and life expectancy.

Keywords: chronic renal insufficiency; renal dialysis; biomarkers; clinical alarms; diagnostic techniques and procedures (MeSH)


Chronic Kidney Disease (CKD) is characterized by the gradual loss of kidney function, culminating in end-stage renal failure. The more chronic the disease, the more likely the emergence of complications-e.g., anemia, electrolyte imbalances, mineral disorders, atherosclerosis.1 These complications, in turn, trigger systemic changes, as is the case of cardiac function. Kidney disease and hemodialysis considerably increase changes in cardiac function, such as cardiomyopathy, diastolic dysfunction, congestive heart failure, coronary heart disease, and vascular changes. 2,3

Even with the advancements achieved in dialysis treatment, both acute and chronic events still involve hemodialysis (HD); that is, patients resume hemodialysis if there is some complication with the remaining modalities of treatment. HD is a procedure in which a machine filters a patient's blood through a venous access to remove harmful residues in order to maintain a balance in electrolyte substances. 4 HD is associated with high mortality, which is nine times higher among patients with CKD than in the general population. More than 50% of deaths are related to cardiac function. Sudden deaths are frequently caused by ventricular arrhythmias associated with HD due to sudden changes in potassium concentration or blood volume. 2 Complications happen and may be severe and fatal. Being aware of complications enables improved prognostic assessment and the employment of intervention strategies. Complications can be identified during anamnesis, physical assessment, or through kidney and cardiac biomarkers and imaging tests. 5

This study's objective was to identify valid blood biomarkers to detect heart failure and kidney failure associated with kidney disease and hemodialysis. This type of research can be useful in identifying studies addressing the context of biomarkers that can be used in the care provided by multidisciplinary teams to individuals with CKD undergoing HD in order to improve the quality of care delivery and intervene in the progression of disease with the purpose of preventing poor outcomes.


Systematic literature review intended to critically assess studies and collect scientific evidence of interventions used to qualify clinical practice. 6 Recommendations provided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (Prisma) were used. 7 Studies were searched in August 2018 in the following databases: Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct and Latin American and Caribbean Health Sciences Literature (LILACS).

The descriptors from the Medical Subject Headings (MeSH) were used and the search was in accordance to the following: ((«heart failure»[MeSH Terms] OR «heart failure»[All Fields] OR «heart failures»[All Fields] OR «Cardiac Failure»[All Fields] OR «Cardiac Failures»[All Fields] OR «Heart Decompensation»[All Fields] OR «Myocardial Failure»[All Fields] OR «Myocardial Failures»[All Fields] OR «Myocardial Decompensation»[All Fields] OR «Cardio-Renal Syndrome»[All Fields] OR «Cardio- Renal Syndro-mes»[All Fields] OR «Renocardiac Syndrome»[All Fields] OR «Renocardiac Syndromes»[All Fields] OR «Cardiorenal Syndrome»[All Fields] OR «Cardiorenal Syndromes»[All Fields] OR «RenoCardiac Syndro-me»[All Fields] OR «Reno-Cardiac Syndromes»[All Fields] OR «renal insufficiency»[MeSH Terms] OR «renal insufficiency»[All Fields] OR «renal insuffi-ciencies»[All Fields] OR «renal failure»[All Fields] OR «renal failures»[All Fields] OR «Kidney Insuffi-ciency»[All Fields] OR «Kidney Insufficiencies»[All Fields] OR «Kidney Failure»[All Fields] OR «Kidney Failures»[All Fields] OR «Renal Failure»[All Fields] OR «Renal Failures»[All Fields]) AND («blood biomarkers»[All Fields] OR «blood biomarker»[All Fields] OR «blood markers»[All Fields] OR «blood marker»[All Fields] OR «Laboratory Markers»[All Fields] OR «Laboratory Marker»[All Fields] OR «Laboratory Biomarkers»[All Fields] OR «Laboratory Biomarker»[All Fields])) AND («Renal Dialysis» [Mesh:noexp] OR «renal dialysis»[All Fields] OR «Renal Dialyses»[All Fields] OR «hemodialysis»[All Fields] OR «haemodialysis»[All Fields] OR «hemodialyses» [All Fields] OR «haemodialyses»[All Fields] OR «Extracorporeal Dialyses»[All Fields] OR «Extracor-poreal Dialysis»[All Fields]).

Studies written in any period or language, answering the following question, were used: "What are the blood biomarkers used to detect heart and kidney failure?" A total of 537 publications were identified, with 94 of these appearing more than once. The titles and abstracts of 443 publications were read and editorials, reflections, experience reports, monographs/dissertations/theses, and event abstracts, were excluded. Of these, 60 studies remained and their respective full texts were assessed. In this process, another 32 studies were excluded because they did not specifically address biomarkers of heart and kidney failure; that is, they addressed associations with other diseases in addition to kidney disease. Thus, 28 studies were taken into account in the qualitative and quantitative synthesis. Ten studies were excluded in this Figure stage because they did not report the Source: methodological model in such a way the study could be reproduced. Eighteen studies remained in the final sample (Figure 1).

Source: own elaboration, 2019.

Figure 1 Flowchart of the different stages of systematic review.  

Level of Evidence (LE) was assessed in accordance to Oxford Centre for Evidence- Based Medicine, 8 which rates the quality of evidence and strength of recommendations, to guide professional practice. Classification ranges from 1 (strong evidence, e.g., systematic reviews and metanalysis) to 5 (weak evidence, e.g., authority/expert opinion). The studies were also assessed using Strengthening the Reporting of Observational Studies in Epidemiology (Strobe), the objective of which is to assess information that needs to be included in the title, abstract, introduction, method, results and discussion of scientific observational studies. Eighteen of the 22 items assessed are common to cohort studies, case-control and sectional studies, while four items are specific to each of the three study designs. Consolidated Standards of Reporting Trials (Consort) was used to assess randomized trials, which is intended to clarify how a study was conducted, its validity and how applicable its conclusions are. For both instruments, studies that met the requirements of the Strobe's 22 items and Consort, were classified as "M" studies (Meets the requirements); as "PM" (Partially Meets the requirements); or classified "DNM" (Does Not Meet the requirements). 8-10


The earliest studies were published in the 2000s and the countries of origin were the United States of America (n: 5), or were located in Europe (n: 7) or South America (n: 6). All the studies used a quantitative approach; most were cohort studies (Table 1).

Table 1 Characteristics of studies in terms of objective, design, and level of evidence. 

Reference Objective Design LE* Strobe Consort
Lacson Jr et al. 11 To assess survival and clinical changes associated with Cohort 1 M M
2012 converting from conventional to nocturnal HD.
Floege et al. 12 2015 To apply a modified Framingham Heart Study approach based on records of HD complications. Cohort 1 M M
Mazur-Laskowska et al. 2 2015 To measure pregnancy-associated plasma protein A (PAPP-A) among HD patients and correlated biomarkers Cohort 2 M M
To determine the relationship between the common
Janda et al. 13 2015 carotid artery intima-media thickness (CCA-IMT) and histologically assess calcification of radial artery in relation to clinical and laboratory characteristics. Transver sal 4 DNM DNM
Vashistha et al. 14 2016 To determine whether red blood cell distribution width
(RBW) is associated with higher mortality rates Cohort 1 M M
among HD patients.
Toledo et al.15 2013 To assess malnutrition and determine mortality among HD patients. Cohort 2 M M
Akgul et al. 16 2008 To verify association between nutritional status, total plasma homocysteine levels, cardiovascular disease, and Cohort 2 M M
mortality among HD patients.
Rocco et al. 17 2011 To identify the benefits of nocturnal HD in compared conventional HD. Cohort 1 M M
Rivara et al.18 To verify whether indications for HD initiation are Cohort 1 M M
2017 associated with mortality.
Karlsson et al} 9 2009 To verify whether decreased kidney function is associated with platelet function among patients with AMI. Cohort 2 M M
Desjardins et al. 20 2014 To assess sclerostin levels in patients with CKD and
association between sclerostin levels, biochemical Cohort 2 M M
parameters in CVD, and mortality.
Aranalde et al.21 2016 To verify whether the concentration of NT-proBNP is related to left ventricular hypertrophy in HD patients. Cohort 3 PM PM
Thome et al. 22 2005 To study inflammatory markers before and 3-6 months after switching water purification system from deionization to reverse osmosis. Cohort 3 M M
Sanchez-Perales et al. 23 2015 To analyze the presence of valve calcification at the beginning of HD and its relationship to cardiovascular Cohort 1 M M
events and/or death.
Martin et al. 24 2011 To verify whether left ventricular hypertrophy can explain association between education and cardiovascular Cohort 1 M M
mortality among HD patients.
Barberato et al. 25 2012 The identify association between systemic inflammation and left atrial enlargement among HD patients without Observat ional 3 PM PM
Morsch et al. 26 2005 To identify association between comorbidities, quantified according to Endstage Renal Disease Severity Index (ESRD-SI), and Kt/V, hematocrit, serum albumin and mortality. Cohort 3 PM PM
Quiroga et al. 21 2015 To determine the predicable value of CK-MB among HDpatients. Cohort 1 M M

Source: own elaboration, 2019

The blood biomarkers used in the studies to detect heart and kidney failure were identified and grouped according to biochemical, hematological, cardiac, cardiovascular, renal and inflammatory parameters that can be used in healthcare practice (Table 2).

Table 2 Details of laboratory tests to identify heart and kidney failure, 2019 

Source: own elaboration, 2019


Laboratory and imaging tests used to identify kidney and heart failure

Imaging tests included Doppler echocardiography, electrocardiogram, ultrasound imaging of the carotid artery and von Kossa’s method, used in histology to detect the presence of calcium in the radial artery. The studies also addressed previous diseases, sociodemo- graphic factors, diabetes mellitus, cardiovascular risk factors, coronary heart disease, stroke, atrial fibrillation, acute myocardial infarction, cancer, and acute lung edema, which were correlated with a risk of mortality and mortality.

Laboratory tests include PAPP-A, which was measured in 78 patients for 60 months and correlated to HD routine tests. The median of PAPP-A levels was two times higher than the upper reference limit (140mIU/L), while values 14 times higher were found. Patients with CKD with cardiovascular events presented higher PAPP-A levels, indicating significant damage to endothelial cells and consequent increased risk of death. This same test was positively associated with serum sodium, potassium, and NT-proBNP. 2,28,29

RDW (iron-deficiency anemia marker), can be used as a marker of nutritional deficiency, inflammation and to predict mortality. 30-32 One study addressing 109,675 patients reports RDW percentages between 14.5% and 17.5%. Association was found between RDW and mortality risk, that is, greater RDW levels were associated with an increased risk of death over time. The pathogenesis of high RDW levels is complex and some hypotheses include a inflammatory process that results from HD, which inhibits bone marrow function, changes iron metabolism, inhibits erythrocyte maturation and promotes oxidative stress leading to increased red blood cell heterogeneity. 14,33,34 The nutritional state of a patient is directly related to hematological changes. One study assessed malnutrition based on three systems: Wolfson, Beberashvili and the International Society of Renal Nutrition and Metabolism (ISRNM). These systems serve to measure nutritional status and predict mortality. ISRNM predicted a fourfold higher risk of death. During the study, 21.5% of the participants died due to malnutrition. 15 Association between malnutrition, inflammation, and comorbidities is one of the reasons for poor outcomes. In this context, one study sought to identify association between nutritional status, total plasma homocysteine (tHcy) levels, cardiovascular disease (CVD), and mortality among 124 patients undergoing HD for two years. The level of tHcy was higher among patients who died due to CVD (8.8%). A positive relationship was found between tHcy and albumin and creatinine. 16,35

Another laboratory text, sclerostin, was assessed in association with vascular disease markers and mortality in 140 patients. High sclerostin levels are correlated with inflammation markers, phosphate, fibroblast growth factor, and arterial stiffness. Mortality was present regardless of age and inflammation parameters. 18 Cardiac events were assessed in 211 patients, considering the cardiac biomarker creatine kinase-MB (CK-MB). The level of CK-MB was 1-2ng/mL, which does not exceed normal laboratory parameters. When it was correlated with other variables to predict cardiovascular events (such as age, sex, other chronic diseases), there was an increase of 17% in the discrimination of risk. 27 Cardiovascular condition was assessed using platelet aggregation during the course of myocardial infarction (AMI) among patients with and without a CKD diagnosis. The study addressing 413 patients with AMI hospitalized in a cardiac intensive care unit presented the following predictors: TFG below 60ml/ min/1.73m2, comorbidities, medications, and inflammation markers and hemostasis. There was significant increase in platelet aggregation in the first three days of hospitalization, regardless of kidney function. This occurs more abruptly in patients with TFG below 60ml/min/ 1.73m2. Advanced age, elevated plasma fibrinogen and diabetes mellitus were associated with platelet aggregation. 19,36,37

One study's objective was to identify the relationship between left ventricular hypertrophy (LVH), mortality and low education level. 24 A total of 113 patients, assigned to two groups, participated in the study: up to three years of schooling and four or more years of schooling. A difference of 5.5 years was found regarding cardiovascular mortality when comparing educational levels. LVH was associated with C-reactive protein, and cardiovascular mortality, as well as creatinine, systemic arterial hypertension, and different educational levels. LVH and risk of mortality was verified using NT-proBNP, cardiovascular failure and hypertrophy markers in a group of adult HD patients. In addition to the laboratory tests, echocardiograms were performed to measure ventricular mass. A highly significant relationship was found between NT- proBNP and LVH; the latter can be a useful biomarker of ventricular mass. A value greater than 10,000pg/ml can identify HD patients with an increased risk of death. 21,38,39

Cases of histological arterial calcification were also verified. The relationship between common carotid artery, intima-media thickness (CCA-IMT) and histological calcification of radial artery in relation to clinical characteristics and laboratory markers, was verified. 13 One study with 59 patients identified significant correlation between CCA-IMT with glucose blood tests, osteoprotegerin and pentraxian 3. Calcification of the radial artery was found in 34 patients who also presented high CCA-IMT. Higher CCA-IMT was associated with more advanced calcifications. The presence of common carotid artery was a positive predictor of calcification of the radial artery, while calcification of the radial artery was a significant predictor of mortality. One study assessed valve calcification in 256 patients and associated it with demographic factors and cardiovascular risk. 23,40 Acute myocardial infarction, stroke and death occurred in 26% of the patients; advanced age, coronary disease, and stroke predicted cardiovascular events. Association between systemic inflammation and left atrial dilatation was found in 58 patients through PCR measurement, interleukin 6 and Doppler echocardiography; high PCR was related to left atrial enlargement. Arteriosclerosis is a major complication of CKD and micro-inflammation is involved in atherogenesis, associated with uremia and dialysis water. 25,41 Therefore, the study verifying dialysis water of two purification systems - deionization and reverse osmosis - addressing 47 patients, showed that uremic cases presented a decrease in PCR levels when water purified via reverse osmosis was used in dialysis, inducing fewer inflammatory processes and lower atherosclerosis. Sixteen of the participants died. 22

Methods to assess the risk of developing and progressing heart failure and kidney failure

The methods to assess the risk of developing and progressing kidney and heart failure include: endstage renal disease severity index (ESRD-SI); Dialysis Outcomes and Practice Patterns Study (DOPPS); European Incident HD Patient Database (AROii); modified Framingham Heart Study approach; and risk of adverse events at the beginning of HD. These were correlated to indicators, laboratory and imaging tests, body mass index, smoking, glomerulonephritis, renal cysts, vascular access, HD complications, and death.

One of the aspects analyzed included indication for HD initiation and mortality. Indications for initiating therapy included laboratory evidence, uremic symptoms, volume overload, and hypertension. Of 461 patients, 183 (40%) died within 2.4 years, on average. After relating HD initiation to demographic variables, coexisting diseases, and glomerular filtration rate, the risk of mortality was 1.69 times greater. 18

The Endstage Renal Disease Severity Index (ESRD-SI) was used by one study to verify association between comorbidities, Kt/V, hematocrit, serum albumin, and mortality. The odds ratio of 40 patients for each ESRD-SI point was 10%; the factors with the greatest impact on mortality were diabetes mellitus, CVD and bone diseases. 26,42,43

Researchers applied a modified approach of the Framingham Heart Study to verify 1- and 2-year mortality rates. They used two European databases. A mortality rate of 13/100 patients/year was found. Increased age, low body mass index, CVD, cancer, venous access catheter, laboratory tests with abnormal results, were identified as predictors of mortality. 12-44

Nocturnal dialysis as an option for clinical management and control of abrupt progression of heart and kidney failure

Nocturnal dialysis was presented in two studies correlating sociodemographic factors, comorbidities and preexisting chronic diseases, laboratory and imaging tests, and dialysis indicators, such as the number of sessions per week, length of sessions, ultra filtrate, and KtV.

One study reports that improved HD results depend on the length of sessions. Thus, the researchers addressed 746 patients undergoing nocturnal HD and 2,062 patients undergoing conventional HD. The mortality rate was lower (19%) among patients undergoing nocturnal HD compared to those undergoing conventional HD (27%). Mortality decreased 25% among patients undergoing nocturnal HD when associated with age, body mass index, length of dialysis, increased interdialytic weight gain, albumin, hemoglobin, dialysis dosage, calcium, decreased pre-dialysis systemic blood pressure, ultrafiltrate rate, phosphorus, and leucocyte count. 9,45-48 Therefore, the study reports that nocturnal HD has favorable clinical features, laboratory biomarkers, and improved survival compared to conventional HD. Although one study addressing 87 patients undergoing conventional HD (n: 42) and nocturnal HD (n: 45) does not report any correlation between different HD modalities and mortality rates, there was an increase in vascular access events, improved control of hyperphosphatemia and systemic arterial hypertension in the case of nocturnal HD. 17,49,50 heart failure and, for this reason, can support the planning of treatment of people with CKD with greater life expectancy and improved quality of life. Preventable complications that lead to kidney and heart disorders and death need to be predicted so that measures can be implemented.


This systematic literature review was intended to identify valid blood biomarkers to detect heart and kidney failure associated with kidney disease and hemodialysis treatment. This review shows that laboratory tests aid the identification of kidney and heart failure among HD patients with CKD. All the studies reported deaths associated with failure of these systems. The studies employed a quantitative approach and were conducted on three continents, in more than 10 different countries. This review's results present the most diverse possibilities of detecting kidney and heart failure and, for this reason, can support the planning of treatment of people with CKD with greater life expectancy and improved quality of life. Preventable complications that lead to kidney and heart disorders and death need to be predicted so that measures can be implemented.


Present work happens with the support of the Coordination of Improvement of Higher Education Personnel (CAPES) - Brazil.


1. Reilly RF, Perazella MA. Nefrologia em 30 dias. 2nd ed. Artmed; 2015. [ Links ]

2. Mazur-Laskwska M, Bala-Bladziñska A, Zegartowska P, Dumnicka P, Zabek-Adamska A, Kapusta M, et al. Serum pregnancy-associated plasma protein A correlates with inflammation and malnutrition in patients treated with maintenance hemodialysis. Folia Med Cracov. 2015 [cited 2019 Apr 21]. Available from: Available from: . [ Links ]

3. Reis MLCA. Síndrome cardiorrenal. Arco Arquivos Centro-Oeste de Cardiología. 2011[cited 2019 Apr 20];(4):20-3. Available from: Available from: . [ Links ]

4. Sociedade Brasileira de Nefrologia (SBN). Tratamento: Hemodiálise. SBN; 2018 [cited 2019 Apr 20]. Available from: Available from: . [ Links ]

5. Barberato SH, Bucharles SGE, Barberato MFA, Pecoits-Folho R. Associação entre Parâmetros Clínicos e Ecodopplercardiográficos com Morte Súbita em Pacientes de Hemodiálise. Arq Bras Cardiol. 2016. [ Links ]

6. Aldemar-Castro A. Revisão Sistemática e Meta-análise. Metodologia. 2001 [cited 2019 Feb 3]. Available from: Available from: . [ Links ]

7. Galvão TF, Pansani TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: a recomendação PRISMA. Epidemiol. Serv. Saúde. 2015;24(2):335-42. [ Links ]

8. Oxford Centre for Evidence-Based Medicine (CEBM). The Oxford 2011 Levels of Evidence. Oxford: CEMB; 2011 [cited 2019 Feb 19]. Available from: Available from: . [ Links ]

9. Malta M, Cardoso LO, Bastos FI, Magnanini MMF, da Silva CMFP. Iniciativa STROBE: subsídios para a comunicação de estudos observacionais. Rev Saúde Pública. 2010;44(3):559-65. [ Links ]

10. Pacheco RL, Garcia CM, Hosni ND, Latorraca COC, Martimbianco ALC, Logullo P, et al. Guidelines para publicações de estudos científicos. Parte 3: como publicar ensaios clínicos. Diagn Tratamento. 2017 [cited 2019 May 29]. Available from: Available from: . [ Links ]

11. Lacson Jr E, Xu J, Suri RS, Nesrallah G, Lindsay R, Garg AX, et al. Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis. J Am Soc Nephrol. 2012;23(4):687-95. [ Links ]

12. Floege J, Gillespie IA, Kronenberg F, Anker SD, Gioni I, Richards S, et al. Development and validation of a predictive mortality risk score from a European hemodialysis cohort. Kidney Int. 2015;87(5):996-1008. [ Links ]

13. Janda K, Krzanowski M, Gajda M, Dumnicka P, Fedak D, Lis GJ, et al. Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. BMC Nephrol. 2015;16:78. [ Links ]

14. Vashistha T, Streja E, Molnar MZ, Rhee CM, Moradi H, Soohoo M, et al. Red Cell Distribution Width and Mortality in Hemodialysis Patients. Am J Kidney Dis. 2016;68(1):110-21. [ Links ]

15. Toledo FR, Antunes AA, Vannini FCD, Silveira LVA, Martin LC, Barretti P, et al. Validity of malnutrition scores for predicting mortality in chronic hemodialysis patients. Int Urol Nephrol. 2013; 45(6):1747-53. [ Links ]

16. Akgul A, Bilgic A, Sezer S, Arat Z, Ozdemir FN, Haberal M. Low Total Plasma Homocysteine Level in Relation to Malnutrition, Inflammation, and Outcome in Hemodialysis Patients. J Ren Nutr. 2008;18(4):338-46. [ Links ]

17. Rocco MV, Lockridge Jr RS, Beck GJ, Eggers PW, Gassman JJ, Greene T, et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 2011;80(10):1080-91. [ Links ]

18. Rivara MB, Chen CH, Nair A, Cobb D, Himmelfarb J, Mehrotra R. Indication for Dialysis Initiation and Mortality in Patients With Chronic Kidney Failure: A Retrospective Cohort Study. Am J Kidney Dis. 2017;69(1):41-50. [ Links ]

19. Karlsson F, Modica A, Mooe T. Association of Level of Kidney Function and Platelet Aggregation in Acute Myocardial Infarction. Am J Kidney Dis. 2009;54(2):262-9. [ Links ]

20. Desjardins L, Liabeuf S, Oliveira RB, Louvet L, Kamel S, Lemke HD, et al. Uremic toxicity and sclerostin in chronic kidney disease patients. Nephrol Ther. 2014;10(6):463-70. [ Links ]

21. Aranalde GI, Girino C, Suita GR. Utilidad del NT-probnp como marcador analítico de hipertrofia ventricular izquierda en pacientes dialíticos. Rev. Med. Rosario. 2016 [cited 2019 Apr 21]. Available from: Available from: ta/aa4158Aranalde.pdf . [ Links ]

22. Thomé FS, Senger M, Garcez C, Garcez J, Chemello C, Manfro RC. Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients. Braz J Med Biol Res. 2005;38(5):89-794. [ Links ]

23. Sanchez-Perales C, Vázquez-Ruiz-de Castroviejob E, García-Cortésa MJ, Biechya MM, Gil-Cunqueroa KM, Borrego-Hinojosa J, et al. Las calcificaciones valvulares al inicio de diálisis predicen la aparición de eventos cardiovasculares en la evolución. Nefrología. 2015;35(2):125.226. [ Links ]

24. Martin RSS, Martin LC, Franco RJS, Barretti P, Caramori JCT, Castro JH, et al. Ventricular Hypertrophy and Cardiovascular Mortality in Hemodialysis Patients With Low Educational Level. Arq Bras Cardiol. 2012;98(1):52-61. [ Links ]

25. Barberato SH, Bucharles SGE, de Souza AM, Costantini CO, CostantiniII; CRF, Pecoits-Filho R. Associação entre Marcadores de Inflamação e Aumento do Átrio Esquerdo em Pacientes de Hemodiálise. Arq Bras Cardiol. 2013;100(2): 141-6. [ Links ]

26. Morsch C, Gonçalves LP, Barros E. Índice de gravidade da doença renal, indicadores assistenciais e mortalidade em pacientes em hemodiálise. Rev Assoc Med Bras. 2005;51(5):296-300. [ Links ]

27. Quiroga B, Vega A, Abad S, Villaverde M, Reque J, López-Gómez JM. Creatine-kinase and dialysis patients, a helpful tool for stratifying cardiovascular risk? Nefrología 2016;3:51-6 [ Links ]

28. Li Y, Zhou C, Zhou X, Song L, Hui R. PAPP-A in cardiac and non-cardiac conditions. Clin Chim Acta. 2013;417:67-72. [ Links ]

29. Pinon P, Kaski JC. Inflamación, aterosclerosis y riesgo cardiovascular: PAPP-A, Lp-PLA2 y cistatina C. ¿Nuevas aportaciones o información redundante?. Rev Esp Cardiol. 2006;59(3):247-58. [ Links ]

30. Ujszaszi A, Molnar MZ, Czira ME, Novak M, Mucsi I. Renal function is independently associated with red cell distribution width in kidney transplant recipients: a potential new auxiliary parameter for the clinical evaluation of patients with chronic kidney disease. Br J Haematol. 2013; 161(5):715-25. 12315. [ Links ]

31. Mucsi I, Ujszaszi A, Czira ME, Novak M, Molnar MZ. Red cell distribution width is associated with mortality in kidney transplant recipients. Int Urol Nephrol. 2014;46(3):641-51. [ Links ]

32. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50(1):40-7. [ Links ]

33. Lu YA, Fan PC, Lee CC, Wu VCC, Tian YC, Yan CW, et al. Red cell distribution width associated with adverse cardiovascular outcomes in patients with chronic kidney disease. BMC Nephrology. 2017;18(1):361. [ Links ]

34. Hsieh YP, Chang CC, Kor CT, Yang Y, Wen YK, Chiu PF. The Predictive Role of Red Cell Distribution Width in Mortality among Chronic Kidney Disease Patients. PLOS ONE. 2016;11(12):e0162025. [ Links ]

35. Canadas-Garre M, Anderson K, McGoldrick J, Maxwell AP, McKnight, AJ. Proteomic and metabolomic approaches in the search for biomarkers in chronic kidney disease. J Proteomics. 2019;193:93-122 [ Links ]

35. Ahmed KAA, Al-Attab WM. Prognostic performance of combined use of high- sensitivity troponin T and creatine kinase MB isoenzyme in high cardiovascular risk patients with end-stage renal disease. Kidney Res Clin Pract. 2017;36(4):358-67. [ Links ]

37. Odum EP, Wakwe VC. Clinical Significance of Creatine Kinase-MB Elevation in Patients with Chronic Kidney Disease before Initiation of Hemodialysis. Cardiology and Angiology: Na International Journal. 2017;6(4):1-7. [ Links ]

38. Chen M, Arcari L, Engel J, Freiwald T, Platschek S, Zhou H, et al. Aortic stiffness is independently associated with interstitial myocardial fibrosis by native T1 and accelerated in the presence of chronic kidney disease. Int J Cardiol Heart Vasc. 2019;24:100389. [ Links ]

39. Niizuma S, Iwanaga Y, Yahata T, Miyazaki S. Renocardiovascular Biomarkers: from the Perspective of Managing Chronic Kidney Disease and Cardiovascular Disease. Front Cardiovasc Med. 2017;4:10. [ Links ]

40. Manousopoulos K, Lykka A, Michas F, Kostogianni K, Koroboki E, Dimitriou A, et al. Association of short-term variability indices with common carotid artery intima-media thickness in chronic kidney disease patients. Journal of Hipertension. 2018;36:e70. [ Links ]

41. Zhao Y, Dong Y, Wang J, Sheng L, Chai Q, Zhang H, et al. Longitudinal association of carotid endothelial shear stress with renal function decline in aging adults with normal renal function: A population-based cohort study. Sci Reps. 2019;9:2051. [ Links ]

42. Sud M, Naimark DMJ. Cardiovascular disease in chronic kidney disease in 2015. Curr Opin Nephrol Hypertens. 2016;25(3):203-7. [ Links ]

43. Dai L, Golembiewska E, Lindholm B, Stenvinkel P. End-Stage Renal Disease, Inflammation and Cardiovascular Outcomes. Contrib Nephrool. 2017;191:32-43. [ Links ]

44. Ataklte F, Song R, Upadhyay A, Ramachandran VS, Xanthakis V. Abstract 14106: Association of Mildly Reduced Estimated Glomerular Filtration Rate With Clinical and Subclinical Cardiovascular Disease and Chronic Kidney Disease: The Framingham Heart Study. Circulation. 2019 [cited 2019 May 20];140:A14106. Available from: Available from: . [ Links ]

45. McCullough PA, Chan CT, Weinhadl ED, Burkart JM, Bakris GL. Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease. Am J Kidney Dis. 2016;68(5S1):S5-14. [ Links ]

46. Netti GS, Rotondi M, Di Lorenzo A, Papantonio D, Teri A, Schirone M, et al. Nocturnal haemodialysis is associated with a reduced occurrence of low triiodothyronine serum levels in haemodialysed patients. Clin Kidney J. 2020;13(3):450-60. [ Links ]

47. Graham-Brown MPM, Churchward DR, Hull KL, Preston R, Pickering WP, Eborall HC, et al. Cardiac Remodelling in Patients Undergoing in-Centre Nocturnal Haemodialysis: Results from the MIDNIGHT Study, a Non-Randomized Controlled Trial. Blood Purif. 2017;44(4):301-10. [ Links ]

48. Roumeliotis A, Roumeliotis S, Chan C, Pierratos A. Cardiovascular Benefits of Extended-Time Nocturnal Hemodialysis. Curr Vasc Pharmacol. 2020. [ Links ]

49. Gan SWS, Chan CT. CKD as CAD Equivalent: Inflammatory Milieu and Vascular Oxidative Stress. In: Rangaswami J, Lerma E, Ronco C, editors. Cardio-Nephrology. 2017 [cited 2020 May 26]. . [ Links ]

50. Shafiee MA, Chamanian P, Shaker P, Shahideh Y, Broumand B. The Impact of Hemodialysis Frequency and Duration on Blood Pressure Management and Quality of Life in End-Stage Renal Disease Patients. Healthcare (Basel). 2017;5(3):52. [ Links ]

Citation: Mayer BLD, Da Costa PTL, Echevarría-Guanilo ME, Kempfer SS, Pieri KMS. Kidney disease and hemodialysis: identification of blood biomarkers to detect heart failure and kidney failure. Rev. Colomb. Nefrol. 2020;7(2):44-54.

Financing There are none

Received: December 09, 2019; Accepted: June 17, 2020

*Correspondence: Barbara Letícia Dudel Mayer,

Conflict of interests

There are none

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License