Comparison of B-type natriuretic peptide and NT proBNP as predictors of survival in patients on high-flux hemodialysis and hemodiafiltration

Sivalingam, Murugan; Suresh, Mithun R; Farrington, Ken

doi:10.1111/j.1542-4758.2011.00557.x

Cited by 17 publications

(19 citation statements)

References 34 publications

(47 reference statements)

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“…After patients consented to the study, their height was recorded and they were carefully weighed and their when undressed to their underwear. Body mass index (BMI) was calculated as weight (kilograms)/(height in meters) . They were asked to lay flat in an examination room at the dialysis unit.…”

Section: Methodsmentioning

confidence: 99%

Which fluid space is affected by ultrafiltration during hemodiafiltration?

Tapolyai

Faludi

Fülöp

et al. 2014

Hemodialysis International

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Ultrafiltration (UF) is a common procedure performed during almost all dialysis sessions. During UF, several liters of fluid are removed; however, what proportion of this fluid is removed from which fluid space could not be clinically measured easily until now; we designed this study to evaluate the fluid spaces most affected by UF. This is a prospective cohort study of 40 prevalent chronic hemodialysis patients receiving thrice weekly hemodiafiltration (HDF). We measured the patients' fluid spaces using a whole-body bioimpedance apparatus to evaluate the changes of fluid spaces before and immediately after the HDF sessions. We recorded the data on fluid spaces, UF volume, and blood pressures. The cohort consisted of 40 prevalent HDF patients, aged 60.0 ± 5.2 years (37.5% men; 27.5% people with diabetes), and body weight 71.03 ± 15.48 kg. Achieved UF was 2.38 ± 0.98 L on HDF (measured fluid overload: 2.35 ± 1.44 L). The extracellular fluid (EC) volume decreased from 16.84 ± 3.52 to 14.89 ± 3.06 L (P < 0.0001) and intracellular fluid (IC) volume from 16.88 ± 4.40 to 16.55 ± 4.48 L (P = 0.45). Although urea volume of distribution remained effectively unchanged (31.38 ± 7.28 vs. 30.70 ± 7.32 L; P = 0.45), the degree of EC volume overload decreased from 13.60% ± 7.30% to 3.83% ± 8.32% (P < 0.0001). The mean arterial pressure also decreased from 122.95 ± 19.02 to 108.50 ± 13.91 mmHg (P < 0.0001). We conclude that source of net fluid loss by ultrafiltration is almost exclusively the EC fluid space. The intracellular fluid space is not significantly affected immediately after HDF.

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Section: Methodsmentioning

confidence: 99%

Which fluid space is affected by ultrafiltration during hemodiafiltration?

Tapolyai

Faludi

Fülöp

et al. 2014

Hemodialysis International

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“…And all of these results benefit the patient by decreasing the risk of CVD. 13,14 This study also compared the status of hypertension and the adequacy of blood pressure control. 76.7% patients were receiving one or more antihypertensive agents to control their hypertension when enrolled.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

Wang

et al. 2013

Renal Failure

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Aims: To investigate the clinical outcomes of maintenance hemodialysis (HD) patients using a high-flux (FX60) dialyzer. Method: Thirty patients undergoing dialysis for at least 2 years with a low-flux dialyzer were switched to the FX60 dialyzer for 3 years. Clinical and biochemical analysis was performed monthly for each patient. The parameters monitored included blood pressure, hemoglobin, albumin, intact parathyroid hormone (iPTH), calcium and phosphorus levels, the adequacy of dialysis (Kt/V), beta2-microglobulin (b2-MG) clearance rate, as well as antihypertensive and erythropoietin (EPO) medications. Results: After 3 years of dialysis with an FX60 dialyzer, the mean arterial blood pressure fell, hemoglobin increased, serum phosphate level decreased, iPTH declined and medication doses decreased. Conclusions: Dialysis with the FX60 dialyzer has a better clinical outcome for rectifying renal anemia, controlling hypertension and lowering serum phosphate levels making it a better choice for long-term HD patients.

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“…Notable is that TnT has molecular size of 37 kDa but also exists as fragments ranging in size from 8 kDa to 30 kDa (26,27), and troponin I has size between 21 kDa to 24 kDa (28). The cardiac markers are all predictors of increased risk of mortality (13,17,18,21,24,(29)(30)(31)(32).…”

Section: Introductionmentioning

confidence: 99%

NT-proBNP and Troponin T Levels Differ after Haemodialysis with a Low versus High Flux Membrane

et al. 2015

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Background Brain natriuretic peptide (BNP), N-terminal-proBNP (NT-proBNP), and high sensitive cardiac troponin T (TnT) are markers that are elevated in chronic kidney disease and correlate with increased risk of mortality. Data are conflicting on the effect of biomarker levels by hemodialysis (HD). Our aim was to clarify to what extent HD with low-flux (LF) versus high-flux (HF) membranes affects the plasma levels of BNP, NT-proBNP, and TnT. Methods and Materials 31 HD patients were included in a crossover design, randomized to start dialysis with a LF-HD or HF-HD dialyzer. Each patient was his/her own control. The dialyses included in the study were the first treatments of two consecutive weeks with each mode of dialysis. Patients normally on hemodiafiltration (HDF) also performed a HDF the third week. Values after HD were corrected for extent of ultrafiltration. Results During LF-HD the biomarkers NT-proBNP and TnT increased (15 versus 6%, P≤.001) while there was a slight decrease in BNP (P<.05). During HF-HD the NT-proBNP, BNP and TnT levels decreased (P≤.01 for all). During HDF all three markers decreased (P<.01 for all). The rise in TnT during LF-HD correlated with dialysis vintage (months on HD, r = .407, P = .026), Kt/V-urea (r = .383, P = .037), HD time in hours/treatment (r = .447, P = .013) and inversely with residual urinary output (r = -.495, P = .005). The baseline levels of BNP and NT-proBNP correlated with blood pressure. Conclusions Cardiac biomarkers increase slightly during LF-HD. A HF-HD eliminates the biomarkers and can mask increases caused by, e.g., myocardial infarction.

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Comparison of B-type natriuretic peptide and NT proBNP as predictors of survival in patients on high-flux hemodialysis and hemodiafiltration

Cited by 17 publications

References 34 publications

Which fluid space is affected by ultrafiltration during hemodiafiltration?

Which fluid space is affected by ultrafiltration during hemodiafiltration?

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

NT-proBNP and Troponin T Levels Differ after Haemodialysis with a Low versus High Flux Membrane

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