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Diagnostic potential of serum biomarkers for left ventricular abnormalities in chronic peritoneal dialysis patients

Angela Yee-Moon Wang1, Christopher Wai-Kei Lam, Mei Wang

  • 1Department of Medicine & Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. aymwang@hku.hk

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 25, 2009
PubMed

Insights

N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and cardiac troponin T (cTnT) effectively diagnose left ventricular abnormalities in peritoneal dialysis patients. Residual renal function impacts biomarker interpretation, requiring adjusted thresholds for anuric patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarker Discovery

Background:

  • Biomarkers like NT-pro-BNP, cTnT, and hs-CRP are known predictors of cardiovascular outcomes in end-stage renal disease.
  • The diagnostic potential for left ventricular (LV) abnormalities and the influence of residual renal function on these biomarkers in chronic peritoneal dialysis (PD) patients remain unclear.

Purpose of the Study:

  • To evaluate the diagnostic value of NT-pro-BNP, cTnT, and hs-CRP for LV abnormalities in chronic PD patients.
  • To determine if residual renal function confounds the diagnostic potential of these biomarkers.

Main Methods:

  • Two hundred and thirty chronic PD patients underwent echocardiography to assess LV hypertrophy and ejection fraction.
  • Simultaneous serum measurements of NT-pro-BNP, cTnT, and hs-CRP were performed.

Main Results:

  • NT-pro-BNP and cTnT significantly improved prediction of severe LV hypertrophy and systolic dysfunction, unlike hs-CRP.
  • NT-pro-BNP demonstrated the highest diagnostic value for LV abnormalities, irrespective of residual renal function.
  • Higher cut-off thresholds for NT-pro-BNP and cTnT were necessary in anuric PD patients compared to those with residual renal function.

Conclusions:

  • Serum NT-pro-BNP is the most valuable biomarker for excluding systolic dysfunction in PD patients, followed by cTnT.
  • hs-CRP is not useful for diagnosing LV abnormalities in this population.
  • Residual renal function complicates biomarker interpretation and necessitates adjusted thresholds in anuric PD patients.
Abstract

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