Chronic renal failure (CRF) results from progressive and irreversible destruction of nephrons, regardless of the cause. Patients with CRF are a major cardiac population. The diagnosis of Myocardial Infarction (MI) is difficult in these patients as they exhibit base line changes in electrocardiogram, echocardiogram and atypical cardiac symptoms. They are not fit for exercise tolerance test. Hence the diagnosis is by Biochemical markers.The present study considers the use of serum cardiac markers

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... for the diagnosis of acute coronary syndromes in patients with CRF without ischemic heart disease with focus on CK MB and AST/SGOT.50 patients with CRF admitted into Government General Hospital and Nagarjuna Hospitals, Vijayawada were assessed for CK MB and AST. Of the 50 patients, 30 of them were on chronic maintenance hemodialysis and 20 were on conservative treatment. 15 of the patients on dialysis were studied for serum cardiac markers before and after dialysis. Patients with previous ischemic heart disease and other related diseases with CK MB elevation were excluded.CK MB levels were elevated in CRF patients than those obtained in healthy controls. They were elevated in those undergoing dialysis and also were elevated in 26% of patients post dialysis compared to levels predialysis. CRF patients had lower AST values compared to healthy individuals. They were also lowered in patients on dialysis but were increased post dialysis compared to predialysis values. Both CK MB and AST show variation in CRF patients but not as in MI. So cardiac markers should be interpreted with caution and other methods for cardiac evaluation should be done in these patients. The results were analyzed by applying Chi-Square test, p value calculated and compared among the three groups. P value <0.0001 and 0.01 which is significant.