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[Value of plasma brain natriuretic peptide detection in cardiac function assessment in hemodialysis patients]
Yong-hong Shao1, Yu-qiong Lai, Ai-zhen Lin
1Department of Nephrology, First People's Hospital of Foshan City, Foshan 528000, China. syhong@fsyyy.com
Insights
Plasma brain natriuretic peptide (BNP) levels are significantly elevated in hemodialysis patients with chronic renal failure (CRF). These levels decrease after dialysis but remain high, correlating with poor cardiac function.
Area of Science:
- Cardiology
- Nephrology
- Biochemistry
Context:
- Chronic renal failure (CRF) patients undergoing hemodialysis often experience cardiovascular complications.
- Brain natriuretic peptide (BNP) is a biomarker used to assess cardiac function.
Purpose:
- To investigate plasma BNP level changes in hemodialysis patients with CRF.
- To evaluate the diagnostic utility of BNP for assessing cardiac function in this population.
Summary:
- Plasma BNP levels were significantly higher in hemodialysis patients with CRF compared to healthy controls.
- BNP levels decreased post-hemodialysis but remained elevated, correlating with left ventricular dilation and reduced ejection fraction (heart failure).
- Elevated BNP levels were strongly associated with impaired cardiac function in CRF patients.
Impact:
- This study highlights the elevated BNP levels in CRF patients and their association with cardiac dysfunction.
- BNP serves as a valuable biomarker for detecting and monitoring cardiac issues in hemodialysis patients.
- Findings support the use of BNP testing for risk stratification and management of cardiovascular disease in CRF.
Objective:
To detect plasma brain natriuretic peptide (BNP) changes in hemodialysis patients with chronic renal failure (CRF) and assess the diagnostic value of BNP for cardiac function.
Methods:
Plasma BNP concentration was measured in 93 hemodialysis patients with CRF and 52 healthy control subjects. In the 93 patients, echocardiographic examinations were performed to determine the relationship between BNP and cardiac function.
Results:
The median plasma BNP levels in 52 normal controls were 3.35 pg/ml (1.00-9.73 pg/ml), and 146.5 pg/ml (56.2-546.9 pg/ml) and 90.0 pg/ml (18.3-310.5 pg/ml) in 93 patients before and after hemodialysis, respectively, showing significant difference among those 3 groups (P<0.001). The plasma BNP levels in patients with CRF complicated by heart failure (LVEF<50%) before and after hemodialysis were 686.0 pg/ml (334.5-1319.3 pg/ml) and 248.0 pg/ml (80.3-814.5 pg/ml) respectively, significantly higher than 62.8 pg/ml (22.0-321.6 pg/ml) and 20.7 pg/ml (1.0-200.9 pg/ml) in patients with normal cardiac function (LVEF > or = 50%) (P=0.002). The plasma BNP levels in patients with dilated left ventricle before and after hemodialysis were 609.0 pg/ml (254-1152.0 pg/ml) and 310.0 pg/ml (28.3-839.6 pg/ml) respectively, significantly higher than 62.8 pg/ml (23.2-192.5 pg/ml) and 22.4 pg/ml (1.0-80.7 pg/ml) in patients with normal left ventricle. Multiple linear regression analysis for left ventricular diastolic dimension, LVEF and plasma BNP level before hemodialysis showed that high BNP level was significantly correlated with dilated left ventricle and poor cardiac function (P<0.01).
Conclusions:
Plasma BNP levels in hemodialysis patients with CRF are significantly higher than those in healthy controls, and are significantly lowered after hemodialysis but still remain higher than the normal level. Plasma BNP levels in hemodialysis patients with dilated left ventricle or heart failure are significantly higher than those in patients with normal left ventricle or cardiac function, and high plasma BNP level is significantly correlated with dilated left ventricle and poor cardiac function.
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