Serum BNP Concentration and Left Ventricular Mass in CAPD and Automated Peritoneal Dialysis Patients

Bavbek, Nüket; Akay, Hatice; Altay, Mustafa; Uz, Ebru; Turgut, Faruk; Uyar, Mehtap Erkmen; Karanfil, A.; Selçoki, Yusuf; Akçay, Ali; Duranay, Murat

doi:10.1177/089686080702700612

Cited by 27 publications

(16 citation statements)

References 39 publications

(40 reference statements)

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“…However, it remains inconclusive and needs more researches [ 186 ]. Meanwhile, due to reduced ultrafiltration rate, continuous volume overload and more LV hypertrophy, patients with automated PD (APD) may have higher BNP levels than those with continuous ambulatory PD (CAPD) [ 187 ]. Moreover, plasma BNP levels have a significant potential to identify LV hypertrophy or dysfunction in patients with different dialysis and renal transplant [ 188 – 190 ].…”

Section: Diagnostic Valuesmentioning

confidence: 99%

Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure

et al. 2018

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As a family of hormones with pleiotropic effects, natriuretic peptide (NP) system includes atrial NP (ANP), B-type NP (BNP), C-type NP (CNP), dendroaspis NP and urodilatin, with NP receptor-A (guanylate cyclase-A), NP receptor-B (guanylate cyclase-B) and NP receptor-C (clearance receptor). These peptides are genetically distinct, but structurally and functionally related for regulating circulatory homeostasis in vertebrates. In humans, ANP and BNP are encoded by NP precursor A (NPPA) and NPPB genes on chromosome 1, whereas CNP is encoded by NPPC on chromosome 2. NPs are synthesized and secreted through certain mechanisms by cardiomyocytes, fibroblasts, endotheliocytes, immune cells (neutrophils, T-cells and macrophages) and immature cells (embryonic stem cells, muscle satellite cells and cardiac precursor cells). They are mainly produced by cardiovascular, brain and renal tissues in response to wall stretch and other causes. NPs provide natriuresis, diuresis, vasodilation, antiproliferation, antihypertrophy, antifibrosis and other cardiometabolic protection. NPs represent body's own antihypertensive system, and provide compensatory protection to counterbalance vasoconstrictor-mitogenic-sodium retaining hormones, released by renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS). NPs play central roles in regulation of heart failure (HF), and are inactivated through not only NP receptor-C, but also neutral endopeptidase (NEP), dipeptidyl peptidase-4 and insulin degrading enzyme. Both BNP and N-terminal proBNP are useful biomarkers to not only make the diagnosis and assess the severity of HF, but also guide the therapy and predict the prognosis in patients with HF. Current NP-augmenting strategies include the synthesis of NPs or agonists to increase NP bioactivity and inhibition of NEP to reduce NP breakdown. Nesiritide has been established as an available therapy, and angiotensin receptor blocker NEP inhibitor (ARNI, LCZ696) has obtained extremely encouraging results with decreased morbidity and mortality. Novel pharmacological approaches based on NPs may promote a therapeutic shift from suppressing the RAAS and SNS to re-balancing neuroendocrine dysregulation in patients with HF. The current review discussed the synthesis, secretion, function and metabolism of NPs, and their diagnostic, therapeutic and prognostic values in HF.

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Section: Diagnostic Valuesmentioning

confidence: 99%

Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure

et al. 2018

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“…and Bavbek et al . examined the incidence of left ventricular mass index (LVMI) in APD and CAPD patients [ 74 , 75 ]. Wang et al .…”

Section: Residual Renal Function–blood Pressure–ultrafiltration–sodiumentioning

confidence: 99%

“…included 32 CAPD and 30 APD patients without clinically evident cardiovascular or valvular heart disease. They also revealed a higher LVMI in APD compared to CAPD patients [ 75 ]. Yet, Jang et al .…”

Section: Residual Renal Function–blood Pressure–ultrafiltration–sodiumentioning

confidence: 99%

APD or CAPD: one glove does not fit all

Roumeliotis

Leivaditis

et al. 2020

Int Urol Nephrol

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The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality. Improved patients' compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis have been also associated with APD. However, concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep are APD's setbacks. Besides APD superiority over CAPD in fast transporters, the other medical advantages of APD still remain controversial. In any case, APD should be readily available for all patients starting PD and the most important indication for its implementation remains patient's choice.

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“…However, since BNP levels remain elevated after significant fluid loss after each dialysis session in both HD patients, other factors must also be involved 27 . Bavbek et al, 29 and Sanjuan et al, 27 found that there was a good correlation between BNP and LVMI, with LVMI being the most significant factor indicating the BNP increase. Sanjuan et al, 27 concluded that in asymptomatic patients, marked increases in BNP levels may reflect very early stages of pathological processes that precede the development of apparent cardiac signs (such as measurable LVH) in patients on extrarenal dialysis.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of left ventricular strain, wall stress and serum brain natriuretic peptide levels in chronic hemodialysis patients

Shawky

Hamdy

Elmadbouly

2018

The Egyptian Heart Journal

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BackgroundLeft ventricular (LV) global longitudinal strain (GLS) reliably assesses LV systolic function. The precise relation between LV wall stress and serum Brain natriuretic peptide (BNP) concentrations in hemodialysis (HD) patients needs to be clarified. BNP levels are raised in patients with end-stage renal disease (ESRD) and could reflect LV impairment among HD patients.Aim of this workThis study sought to evaluate the clinical utility of LV-GLS, wall stress and serum BNP levels in chronic HD patients. The correlations between BNP levels with both LV wall stress and LV-GLS were assessed.Patients and methods30 ESRD patients on regular HD {categorized into 15 patients with LV ejection fraction (EF) ≤ 50% and 15 patients with LV EF > 50%} and 15-age matched healthy subjects were included. LV function and structure were assessed by conventional echocardiography including LV meridional wall stress (LVMWS), LV mass index (LVMI) and 2-dimensional speckle tracking echocardiography for determination of LV-GLS. Serum BNP levels were evaluated after HD session.ResultsThere were significant increase of LVMSW (189.2 ± 81 vs. 72.2 ± 20.6 dynes/cm2 × 1000, P < 0.0001), higher levels of BNP (1238 ± 1085.5 vs. 71 ± 23.4 pg/ml, P < 0.0001) while LV-GLS was significantly reduced (15.1 ± 3.1 vs. 20.8 ± 1.7%, P < 0.0001) in HD patients compared to controls. Higher values of LVMWS (246.9 ± 67.5 vs. 131.5 ± 43.6 dynes/cm2 × 1000, P < 0.0001) and BNP (1925.4 ± 1087 vs. 550.5 ± 496.5 pg/ml, P < 0.0005) with further impairment of LV-GLS (13.8 ± 2.5 vs. 16.4 ± 5.4%, P < 0.05) were found in patients with LV EF ≤ 50% than those with LV EF > 50%. Serum levels of BNP were positively correlated with LVMI (r = 0.896, P < 0.0001) and LVMWS (r = 0.697, P < 0.0001) but negatively correlated with LV-GLS (r = −0.587, P < 0.0001).ConclusionLV-GLS and LVMWS are useful imaging markers for detection of LV dysfunction in HD patients. Serum BNP level is influenced by LV structural abnormalities and suggested to be a crucial hemodynamic biomarker in those patients.

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Serum BNP Concentration and Left Ventricular Mass in CAPD and Automated Peritoneal Dialysis Patients

Cited by 27 publications

References 39 publications

Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure

Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure

APD or CAPD: one glove does not fit all

Clinical utility of left ventricular strain, wall stress and serum brain natriuretic peptide levels in chronic hemodialysis patients

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