TY - JOUR
T1 - Plasma B-type natriuretic peptide in dialyzed patients
T2 - Marker of cardiovascular disease or link to plasma refilling?
AU - de Mauri, Andreana
AU - Bellomo, Giorgio
AU - Navino, Carlo
AU - David, Paola
AU - Chiarinotti, Doriana
AU - Capurro, Federica
AU - Brustia, Maddalena
AU - de Maria, Mariangela
AU - Ruva, Carlo Edoardo
AU - Ciardi, Laura
AU - de Leo, Martino
PY - 2011/7
Y1 - 2011/7
N2 - Background: B-type natriuretic peptide (BNP) is released in response to extracellular volume and blood pressure (BP) overload and is a risk factor for cardiovascular diseases (CVD). BNP is increased in dialyzed patients (HDpts). The aim of this study was to evaluate the relationships between BNP and renin, aldosterone and blood volume reduction rate (BV/WL), with the presence of CVD and mortality. Methods: Fifty-one HDpts aged 70 ± 14 years were enrolled. BP, BV/WL, BNP, aldosterone, renin, C-reactive protein (CRP), troponin I and routine biochemistry were measured. According to the predialytic plasma BNP levels, the patients were divided into group A with higher BNP and group B with lower BNP than the median value of 330 pg/mL. Follow-up was 1 year. Results: After HD, plasma BNP (449.6 ± 582.2 pg/ mL vs. 264.1 ± 269.8 pg/mL, p=0.0008) and aldosterone (421.8 ± 573.4 pg/mL vs 265.1 ± 566.2 pg/mL, p=0.0003) decreased, but not rennin. BNP decreased more after hemodiafiltration than after standard HD (-55.1% ± 28.5% vs. -26.5% ± 19.5%, p=0.002). Patients in group A exhibited more diabetes (58% vs. 28%, p=0.03), ischemic heart disease (42% vs. 16%, p=0.04), left ventricular hypertrophy (88.8% vs. 33.3%, p<0.001), elevated levels of troponin I, CRP (50% vs. 24%, p=0.05), and low BV/BWL in a lower percentage (8% vs. 32%, p=0.03). After 11.2 ± 3.5 months, 8 patients (33.3%) had died in group A and 2 (8%) in group B (p=0.02). Conclusion: This study demonstrates that BNP is high in HDpts and decreases after HD. It is correlated with a good capacity for plasma refilling, with diabetes, CVD and short-term mortality risk.
AB - Background: B-type natriuretic peptide (BNP) is released in response to extracellular volume and blood pressure (BP) overload and is a risk factor for cardiovascular diseases (CVD). BNP is increased in dialyzed patients (HDpts). The aim of this study was to evaluate the relationships between BNP and renin, aldosterone and blood volume reduction rate (BV/WL), with the presence of CVD and mortality. Methods: Fifty-one HDpts aged 70 ± 14 years were enrolled. BP, BV/WL, BNP, aldosterone, renin, C-reactive protein (CRP), troponin I and routine biochemistry were measured. According to the predialytic plasma BNP levels, the patients were divided into group A with higher BNP and group B with lower BNP than the median value of 330 pg/mL. Follow-up was 1 year. Results: After HD, plasma BNP (449.6 ± 582.2 pg/ mL vs. 264.1 ± 269.8 pg/mL, p=0.0008) and aldosterone (421.8 ± 573.4 pg/mL vs 265.1 ± 566.2 pg/mL, p=0.0003) decreased, but not rennin. BNP decreased more after hemodiafiltration than after standard HD (-55.1% ± 28.5% vs. -26.5% ± 19.5%, p=0.002). Patients in group A exhibited more diabetes (58% vs. 28%, p=0.03), ischemic heart disease (42% vs. 16%, p=0.04), left ventricular hypertrophy (88.8% vs. 33.3%, p<0.001), elevated levels of troponin I, CRP (50% vs. 24%, p=0.05), and low BV/BWL in a lower percentage (8% vs. 32%, p=0.03). After 11.2 ± 3.5 months, 8 patients (33.3%) had died in group A and 2 (8%) in group B (p=0.02). Conclusion: This study demonstrates that BNP is high in HDpts and decreases after HD. It is correlated with a good capacity for plasma refilling, with diabetes, CVD and short-term mortality risk.
KW - B-type natriuretic peptide
KW - Blood volume
KW - Cardiovascular disease
KW - Plasma refilling
UR - http://www.scopus.com/inward/record.url?scp=79960325303&partnerID=8YFLogxK
U2 - 10.5301/JN.2011.6240
DO - 10.5301/JN.2011.6240
M3 - Article
SN - 1121-8428
VL - 24
SP - 507
EP - 514
JO - Journal of Nephrology
JF - Journal of Nephrology
IS - 4
ER -