Clinical significance of N-terminal Pro-B-type natriuretic peptide (NT-proBNP) in hemodialysis patients.
Circulating biomarkers play a major role in the early detection of cardiovascular disease. The purpose of this study was to determine levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in hemodialysis (HD) patients and to examine the relationship of this marker to left ventricular hypertrophy and to cardiac dysfunction. Plasma NT-proBNP concentrations were measured in patients undergoing chronic HD, who did not any clinical evidence of heart failure, (n=32; mean age 43.14 +/- 12 years; sex-ratio 1.8) as well as healthy volunteers (n=32; mean age 45.84 +/- 1.9 years; sex-ratio 1). In addition, the correlation between plasma NT-proBNP concentration and parameters of echocardiography was examined. The plasma NT-proBNP levels in the HD patients were significantly higher (14422.6 +/- 13757.8 pg/mL) than those in healthy volunteers (39.21 pg/mL) (P< 10 -3 ). In addition, the area under the receiver operating characteristic curve (ROC) revealed that the cut-off level of NT-proBNP was 288 pg/mL. On univariate analysis, the plasma NT-proBNP concentrations, in patients on HD, correlated positively with age (P= 0.004; r=0.5), systolic (P= 0.046; r= 0.36) and diastolic blood pressures (P= 0.037; r= 0.37), residual diuresis (P= 0.09; r= 0.3), the left atrial diameter (LAD) (P= 0.006; r= 0.55), left ventricular mass index (LVMI) (P= 0.01; r= 0.44) and negatively with albumin (P= 0.01; r= -0.44). However, there was no correlation between plasma levels of NT-proBNP and gender, body mass index (BMI), mean period on dialysis, pulse pressure, dry weight and left ventricular dysfunction. On multivariate analysis, only age (P= 0.014, RR= 2.8) was associated with significantly increased levels of NT-proBNP. Further studies are needed to carefully assess the diagnostic accuracy and prognostic value of NT-proBNP in patients on HD.
Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia. imedhelal@voila.fr
Imed
I
Helal
Raja
R
Belhadj
Amira
A
Mohseni
Lilia
L
Bazdeh
Habiba
H
Drissa
Fethi
F
Elyounsi
Taieb Ben
TB
Abdallah
Jaouida
J
Abdelmoula
Adel
A
Kheder
D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain