[Relationship between B-type natriuretic peptide plasma level and left ventricular function in patients with chronic...

To evaluate relationship between echocardiography finding of LV mass and function and B-type natriuretic peptide (BNP) plasma level in patients with chronic kidney disease on different type of treatment.

We performed comparative examine on a parallel groups of kidney patients with no clinical signs of heart failure: 25 patients with chronic kidney disease (CKD, creatinine klirens < 60 ml/min), 25 patients on peritoneal dialysis (PD), 34 patients on hemodialysis (HD) and 22 renal transplant patients. Each patient underwent echocardiography investigations and measured plasma level B-type natriuretic peptide.

It was determined that hemodialysis patients had higher value of left ventricular mass index (LVMI). The incidence of left ventricular hypertrophy (LVH) progressive increased from CKD patients to HD patients (78.6% vs. 88.9%), as well as a plasma level of B-type natriuretic peptide (174.2 vs. 1020.2 pg/ml). There was a significant positive correlation between LVMI and BNP plasma level in CKD (p = 0.008) and HD patients (p = 0.001), as well as significant negative correlation between BNP plasma level and LV diastolicfunction in CKD patients (p = 0.002).

Plasma BNP concentration was elevated in renal dysfunction. Plasma BNP levels and the incidence of LVH were significantly grater in HD patients than in other renal patients. Significant positive correlation between plasma BNP level and LVMI suggested simultaneous influence of renal dysfunction and plasma BNP level on development of LV dysfunction.