Is Brain Natriuretic Peptide a Reliable Biomarker of Hydration Status in All Peritoneal Dialysis Patients?

Abstract

Background: Achievement of euvolemia is a fundamental challenge in the peritoneal dialysis (PD) population. Bioimpedance spectroscopy (BIS) is one of the best techniques for routine assessment of hydration status (HS) in PD, but in recent years, the role of brain natriuretic peptides (BNP) in the assessment of volume status has gained interest. The aim of this study was to investigate the relation between BNP and volume status as measured by BIS in PD patients and to assess how these variables correlate according to the time that a patient has been on PD. Methods: We prospectively studied 68 PD patients from whom measurements of BNP and assessments of HS by BIS were performed every 3 months. Three groups were defined based on HS: group A, measurements of HS <-1.1 liters (underhydrated); group B, measurements of HS between -1.1 and +1.1 liters (normohydrated), and group C, measurements of HS >+1.1 liters (overhydrated). Measurements were also separated according to the time on PD (<6 vs. ≥6 months). Correlation between HS and BNP was performed using Spearman's correlation. Results: We performed a total of 478 measurements of HS and BNP. There was a statistically significant difference in BNP (p < 0.001) among three HS groups, with higher levels of BNP detected in overhydrated patients. We found a positive correlation between HS and BNP (r_s = 0.28; p <0.001) that seemed stronger in the first 6 months on PD (r_s = 0.42; p = 0.006). Conclusions: BNP correlated positively with fluid overload measured by HS, and this correlation was stronger in the first 6 months on PD.

NT‐proBNPand cardiac troponin I concentrations in dogs with tick paralysis caused byIxodes holocyclus

“…23 As such, our results suggested that myocardial wall stress was reduced in dogs with tick paralysis, regardless of their state of respiratory compromise. [42][43][44][45][46] Future studies could investigate the presence or absence of significant dehydration in dogs with tick paralysis using additional indicators of hydration status such as urine specific gravity and total serum protein concentration, 47 and body weight at admission and after recovery. Furthermore, many dogs with tick paralysis vomit or regurgitate, possibly also contributing to a reduction in preload.…”

“…It has been shown in dogs and a range of other species that dehydration in the acute setting similarly decreases plasma natriuretic peptide concentrations. [42][43][44][45][46] Future studies could investigate the presence or absence of significant dehydration in dogs with tick paralysis using additional indicators of hydration status such as urine specific gravity and total serum protein concentration, 47 and body weight at admission and after recovery.…”

The role of brain natriuretic peptide in predicting renal outcome and fluid management in critically ill patients

“…24 Furthermore, BNP may be used to predict mortality and to guide fluid management in hemodialysis patients. 25,26 In our study, we chose BNP because of its short half-life and relative independence from the glomerular filtration rate and patient's age, compared to NT pro-BNP. 27,28 de Cal et al 29 report that increased BNP levels are associated with AKI development on ICU admission or during the ICU stay.…”

Influência da sobrecarga de líquidos sobre estado nutricional, gasto energético de repouso e biomarcador de risco cardiovascular em pacientes tratados por diálise peritoneal

“…Na avaliação dos exames bioquímicos, o único que apresentou diferença significativa entre os grupos foi o NT pró -BNP, pacientes HH apresentaram níveis mais elevados do mesmo, resultado semelhante foi encontrado por Kocyigit et al, (2014) e Crepaldi et al, (2014).…”

“…A meia-vida mais longa de NT pró -BNP pode torná-lo um índice mais preciso da tensão ventricular e, consequentemente, um melhor indicador de prognóstico ao compará-lo com o BNP. Outros exames como o ecocardiograma devem ser utilizados para avaliar as alterações cardíacas (CREPALDI et al, 2014). (BIESEN, et al, 2011;CADER et al, 2013;FERNANDEZ et al, 2013,).…”