title: Impact of acute renal failure on the relationship between N-terminal pro-B-type natriuretic peptide and hemodynamic parameters.
abstract: BACKGROUND
  We studied the influence of acute renal failure (ARF) on the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and hemodynamic parameters.
  
  
  METHODS
  The echocardiographic parameters and NT-proBNP levels were compared between 26 mechanically ventilated patients with ARF requiring continuous hemodiafiltration and 44 control patients.
  
  
  RESULTS
  The relationships between NT-proBNP and left ventricular ejection fraction (p = 0.001), left ventricular end-diastolic volume (p = 0.03), tricuspid annular plane systolic excursion (p = 0.008), and pulmonary artery pressure (p = 0.01) were found only in the control group. The median and interquartile range of NT-proBNP (1,717.5, 389.5-4,138 ng/l) were significantly higher (p < 0.001) in the low diuresis subgroup than the levels (748.8, 384.2-2,217 ng/l) in the subgroup where daily diuresis increased and both had significantly higher levels than controls (350.7, 130.2-661.2 ng/l, p < 0.001).
  
  
  CONCLUSIONS
  The high levels of NT-proBNP >1,000 ng/l seem to be typical, particularly for oliguric ARF. It seems that ARF precludes its utilization for any hemodynamic diagnosis.
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital in Prague, U nemocnice 2, Prague, Czech Republic. martin.balik@post.cz
authors.forename: Martin
authors.initials: M
authors.lastname: Balik
authors.forename: Antonin
authors.initials: A
authors.lastname: Jabor
authors.forename: Michal
authors.initials: M
authors.lastname: Otahal
authors.forename: Petr
authors.initials: P
authors.lastname: Waldauf
authors.forename: Marie
authors.initials: M
authors.lastname: Pavlisova
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain