Plasma Brain Natriuretic Peptide Levels in Cardiac Function Assessment in Chronic Dialysis Patients

Sanjuán, Rafael; Oliva, Stefano; Blasco, María Luisa; Puchades, María Jesús; Torregrosa, Isidro; Ramón, R. García; Carrasco, A. Miguel

doi:10.1159/000329337

Cited by 12 publications

(23 citation statements)

References 36 publications

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“…Our results clearly show that patients on HD are more likely to have elevated levels of NT-proBNP compared to patients on CAPD, and this finding may suggest that from the cardiovascular stand point CAPD is a better alternative to HD for renal replacement therapy. These data are consistent with previously mentioned studies [27][28][29] . Whether an advantage predicted by a marker such as NT-proBNP leads to an actual morbidity or mortality benefit cannot be determined from the present study, and this clinically relevant hypothesis warrants further investigation.…”

Section: Abnormal Nt-probnp In Hd Vs Capdsupporting

confidence: 94%

“…The thought that such volume shifts would have adverse effect on the cardiovascular system have been postulated before, and there is an accumulating body of evidence suggesting that BNP and NT-proBNP levels are higher among patients on HD (ref. [27][28][29][30]. No previous studies to our knowledge assessed NT-proBNP according to the level of preservation of the left ventricular systolic function.…”

Section: Abnormal Nt-probnp In Hd Vs Capdmentioning

confidence: 99%

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Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients

Ludka¹,

Špinar²,

Tomandl³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Plasma N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) concentration is elevated in cardiovascular diseases such as congestive heart failure, where increased levels of NT-proBNP indicate cardiac dysfunction, hypervolemia, and higher risk of hospitalization and death. These associations apply also to patients with severe impairment of kidney function. Little is known about diferences in plasma level of NT-proBNP in patients receiving hemodialysis (HD) versus those receiving continuous ambulatory peritoneal dialysis (CAPD). Aim. To evaluate differences in plasma NT-proBNP concentration between HD and CAPD patients. Methods. Plasma NT-proBNP concentration was prospectively measured in consecutive patients receiving either HD or CAPD at our hospital center. All other standard clinical parameters were recorded. The correlation between plasma NT-proBNP concentration and the type of dialysis was then examined. Results. We studied 99 consecutive patients on HD (age 62 ± 15 years, 66% male) and 18 consecutive patients on CAPD (age 56 ± 18 years, 67% male). Both groups had similar baseline characteristics including duration of dialysis, left ventricular function and mass, and cardiothoracic ratio. Significantly more patients on HD had abnormal NTproBNP levels compared to patients on CAPD (97% vs 44%; P<0.0001), and this difference remained highly significant when using various NT-proBNP cut off values. A subgroup analysis revealed that the lower NT-proBNP levels of CAPD patients are most pronounced in patients with preserved left ventricular ejection function. As expected, NT-proBNP levels correlated negatively with left ventricular function and positively with cardiothoracic ratio, and this applied to both HD and CAPD groups. Conclusion. The lower concentration of NT-proBNP in patients on CAPD compared to those on HD suggests that CAPD produces lesser hemodynamic stress, especially in patients with preserved left ventricular systolic function. Even though increased NT-proBNP levels have been shown to predict increased morbidity and mortality, further studies are necessary to assess the long term benefit of CAPD compared to HD.

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Section: Abnormal Nt-probnp In Hd Vs Capdsupporting

confidence: 94%

Section: Abnormal Nt-probnp In Hd Vs Capdmentioning

confidence: 99%

Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients

Ludka¹,

Špinar²,

Tomandl³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…34 It has also been shown that BNP has a good predictive power for the total and CVD mortality in patients with ESRD. [14][15][16][17]35 Mallamaci et al 16 also showed that cardiac natriuretic peptides, particularly BNP, had a high sensitivity in diagnosing LVH and systolic dysfunction in patients with dialysis. In our study, we found that BNP had a negative correlation with residual diuresis in MHD patients.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,8 Many studies have been carried out to discover useful prognostic markers for MHD patients. For instance, blood total homocysteine (tHcy) [9][10][11][12][13] and B-type natriuretic peptide (BNP) [14][15][16][17] have been shown to have good predictive power for the total and cardiovascular disease (CVD) mortality in patients with end-stage renal disease (ESRD). Both tHcy and BNP are useful in identifying LVH or depressed left ventricular systolic function in asymptomatic ESRD patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Residual Renal Function on Left Ventricle and Analysis of Related Factors in Patients with Hemodialysis

Ding

2012

Renal Failure

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Background: Left ventricular hypertrophy (LVH) and systolic dysfunction would predict the mortality of patients undergoing maintenance hemodialysis. The cause of LVH is usually related to the increase of total peripheral vascular resistance and overloading volume. The presence of residual diuresis enables greater control of the volume. This study evaluated the effects of residual renal function (RRF) on the left ventricle and analyzed the related factors involved in hemodialysis patients. Methods: A total of 59 hemodialysis patients were classified into two groups. The patients in the RRF (RRFþ) group had a urine volume greater than 200 mL/24 h, and the patients in the non-RRF (RRFÀ) group had a urine volume less than 200 mL/24 h. B-type natriuretic peptide (BNP), blood total homocysteine (tHcy), and blood biochemical indexes were determined for the patients in both groups. Echocardiography and Doppler tests were performed to determine the cardiac indexes. Results: LVH and systolic dysfunction in the RRFþ group were less severe than those in the RRFÀ group. The concentration of tHcy and BNP in patients with RRF was decreased in comparison with those without RRF. The concentration of tHcy and BNP was positively correlated with the residual diuresis. Conclusions: There were distinct ventricular geometric patterns and different functional performances between RRFþ and RRFÀ groups. The presence of residual diuresis had a beneficial effect on the left ventricular function in hemodialysis patients.

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“…Hemodialysis studies of cardiac biomarkers present conflicting results, with either increasing, decreasing, or stable values post-dialysis as compared to pre-dialysis (16,17,22,33,34) (16,(34)(35)(36)(37)(38)(39). Even when measuring NT-proBNP and BNP in dialysate the results are conflicting (38,40).…”

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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Plasma Brain Natriuretic Peptide Levels in Cardiac Function Assessment in Chronic Dialysis Patients

Cited by 12 publications

References 36 publications

Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients

Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients

Effects of Residual Renal Function on Left Ventricle and Analysis of Related Factors in Patients with Hemodialysis

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

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