Brain natriuretic peptide variations are linked to volume status in hemodialysis patients

Roueff, S.; Martin, Erika J.; Ml, Chauffert; Poli, Irene; Kihal, K; Yazbeck, F.; Abbassi, Abdelhamid; Saint-Georges, M. D.

doi:10.5414/cnp70508

Cited by 13 publications

(17 citation statements)

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“…An increase in BNP concentration over time in dialysis patients has been previously demonstrated for both NT-BNP-76 (7,14,15) and BNP-32 (16), although two other studies demonstrated no significant change in these markers (17,18). The concurrent measurement of both forms of BNP in three groups of patients allowed us to directly compare patients with CKD 3-4 and KTRs to dialysis patients.…”

Section: Discussionmentioning

confidence: 92%

“…All samples in this study were collected just before the hemodialysis procedure to eliminate effects of this procedure (19,20). Studies of the effect of vascular access creation on BNP concentrations are inconclusive (21,22), and studies of BNP as a biomarker of volume overload in patients receiving dialysis also vary in their conclusions (15,16,18).…”

Section: Discussionmentioning

confidence: 99%

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Temporal Trajectory of B-Type Natriuretic Peptide in Patients with CKD Stages 3 and 4, Dialysis, and Kidney Transplant

Roberts

Hare

Sikaris³

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives B-type natriuretic peptide (BNP) concentration predicts outcome in patients undergoing dialysis. Because survival and cardiovascular risk change across the CKD continuum, serial changes in BNP were compared in patients at different CKD stages and after kidney transplantation.Design, setting, participants, & measurements Patients with CKD stages 3 and 4 (CKD 3-4), dialysis patients, and kidney transplant recipients (KTRs) from one center had two measurements of BNP taken a median of 161 days apart in 2003-2004 and were followed until July 2012. Both BNP-32 (Triage BNP; Biosite Diagnostics) and NT-BNP-76 (proBNP; Roche Diagnostics) were assayed. The interaction between change in log-transformed BNP concentration over time and patient group was tested by fitting regression models on panel data with random effects. Survival after the second measurement was compared by tertile of change in BNP.Results Patients with CKD 3-4 (n=48), dialysis patients (n=102), and KTRs (n=73) were followed for a median of 5.7, 4.8, and 5.9 years, respectively. The interaction between patient group and BNP measurements over time was significant for NT-BNP-76 (P,0.001) and BNP-32 (P,0.01). Median NT-BNP-76 increased in dialysis patients and those with CKD 3-4 from 3850 pg/ml (interquartile range [IQR], 1776-12,323 pg/ml) to 18,830 pg/ml (IQR, 6114-61,009 pg/ml; P,0.001) and from 698 pg/ml (IQR, 283-2922 pg/ml) to 2529 pg/ml (IQR, 347-9277 pg/ml; P=0.002), respectively. Change was not significant for KTRs or comparisons made with BNP-32. Survival rate was significantly lower for patients with the highest tertile of change in NT-BNP-76 among patients with CKD 3-4 (P=0.02), but not in the dialysis or KTR groups. In 11 patients who received a kidney transplant during the study, median NT-BNP-76 decreased from 9607 pg/ml (IQR, 2292-31,282 pg/ml) to 457 pg/ml (IQR, 203-863 pg/ml) after transplant (P,0.01).Conclusions The temporal trajectory of BNP differs between dialysis patients and those with CKD 3-4 and KTRs. This has important implications for the development of BNP-guided management strategies in CKD.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Temporal Trajectory of B-Type Natriuretic Peptide in Patients with CKD Stages 3 and 4, Dialysis, and Kidney Transplant

Roberts

Hare

Sikaris³

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Our aim was to discriminate homogeneous groups of patients without significant renal failure (Group 1) and with end-stage renal disease (Group 2). Because of the small number (13) Analytical methods. The amyloidogenic monoclonal component was detected in serum and/or urine by high-resolution immunofixation electrophoresis and the circulating free light chains were quantified in all patients [20].…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, studies in patients with nonamyloid cardiac disease have shown that both BNP and NT-proBNP are associated with echocardiographic findings and predict survival in patients with CKD and in those undergoing hemodialysis and peritoneal dialysis, but it has been suggested that BNP can be a more appropriate marker of cardiac dysfunction than NT-proBNP in subjects with reduced glomerular filtration rate [9]. Moreover, intravascular volume modifications influence the concentration of natriuretic peptides in patients undergoing hemodialysis [12,13].…”

Section: Introductionmentioning

confidence: 99%

Best use of cardiac biomarkers in patients with AL amyloidosis and renal failure

et al. 2012

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In AL amyloidosis prognosis depends on the severity of heart dysfunction which is best assessed by natriuretic peptides (BNP and NT-proBNP). However, their clearance relies on glomerular filtration rate (GFR) and their concentration increases with renal failure. We evaluated the diagnostic and prognostic performance of NT-proBNP and BNP in 248 patients with AL amyloidosis with different degrees of renal failure. Patients were grouped according to GFR. Group 1 comprised 109 patients with GFR 60 mL/min/1.73 m 2 , Group 2, 77 subjects with GFR <60 and 15 mL/min/1.73 m 2 , and Group 3, 62 patients with GFR <15 mL/ min/1.73 m 2 . The ability of natriuretic peptides to detect heart involvement and to predict survival in the three groups was assessed. Decreasing eGFR required higher cutoffs of both NT-proBNP and BNP for detecting heart involvement and predicting survival. Both natriuretic peptides were independent prognostic markers in Groups 1 and 2, whereas in Group 3 only BNP independently predicted survival. Natriuretic peptides are powerful and useful markers of cardiac dysfunction and prognosis, provided that eGFR is considered in interpreting their clinical meaning. BNP should be preferred in patients with end-stage renal failure. Am. J. Hematol. 87:465-471, 2012. V

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“…Furthermore, BNP is used for volume estimation in dialysis patients, since BNP level variations correlate positively with volume status alterations in this specific patient group [46].…”

Section: Characteristicsmentioning

confidence: 99%

Hormones and Nocturia: Guidelines for Medical Treatment?

Goessaert

Johan²,

Walle³

et al. 2013

J Steroids Horm Sci

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Nocturnal polyuria (NP) is an important cause of nocturia and it is related to an imbalance in water and/or sodium homeostasis. Antidiuretic hormone (ADH) and atrial natriuretic peptide (ANP) are believed to play an important role in this excessive urine production overnight, however, many other hormones are involved. ADH and ANP are both directly and indirectly influenced by the renin-angiotensin-aldosterone system (RAAS), prostaglandins antagonize both ADH and RAAS and sex hormones have a predominantly antidiuretic effect by stimulating ADH and RAAS, meaning that any disturbance can lead to an imbalance in diuresis. Since nocturia is a condition affecting sleep, melatonin secretion can also be affected, leading to a decrease in the antidiuretic effect and to an increase of nocturnal urine production. Depending on the underlying condition affecting any of these hormones, a more specific therapeutic approach might lead to a restoration of the normal diuresis cycle and to a good night's sleep. The characteristics of each of these hormones, the pathophysiology in NP and the therapeutic implications are set out in this review.

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Brain natriuretic peptide variations are linked to volume status in hemodialysis patients

Cited by 13 publications

References 0 publications

Temporal Trajectory of B-Type Natriuretic Peptide in Patients with CKD Stages 3 and 4, Dialysis, and Kidney Transplant

Temporal Trajectory of B-Type Natriuretic Peptide in Patients with CKD Stages 3 and 4, Dialysis, and Kidney Transplant

Best use of cardiac biomarkers in patients with AL amyloidosis and renal failure

Hormones and Nocturia: Guidelines for Medical Treatment?

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