title: Is N-terminal probrain-type natriuretic peptide a clinically useful biomarker of volume overload in peritoneal dialysis patients?
abstract: BACKGROUND
  Brain natriuretic peptide (BNP) has been reported to be a powerful predictor of peritoneal dialysis patient survival. However, it is unclear as to whether this is related to cardiac dysfunction or chronic volume overload.
  
  
  METHODS
  To investigate the relationship between BNP, cardiac function and fluid volume overload, we reviewed multifrequency bioimpedance, transthoracic echocardiography and serum N-terminal probrain-type natriuretic peptide (NTproBNP) in 115 stable peritoneal dialysis outpatients attending for assessment of peritoneal dialysis and transport status.
  
  
  RESULTS
  In this cross-sectional study, the median NTproBNP was 251 (118-605) pmol/L. On simple univariate analysis, NTproBNP was associated with markers of residual renal function, volume overload, hypertension and hypertensive cardiac disease and inflammation [reduced serum albumin and raised C-reactive protein]. However, on multivariate logistical regression analysis, the strongest association for log NTproBNP was with the estimated right ventricular end-systolic pressure (β = 0.02, F = 11.5, P = 0.001), followed by log 24-h urine volume (β = -0.19, F = 10.7, P = 0.002), extracellular/total body water ratio (β = 13.5, F = 6.1, P = 0.017) and the number of different antihypertensive medications prescribed (β = 0.15, F = 8.7, P = 0.005).
  
  
  CONCLUSIONS
  In this cross-sectional study, although NTproBNP was associated with residual renal function, cardiac hypertrophy, volume overload and inflammation on simple univariate analysis, on further examination NTproBNP was predominantly affected by factors associated with volume overload, and these results require confirmation in a prospective study.
authors.affiliation: UCL Centre for Nephrology, Royal Free Hospital, University College London Medical School, London, UK.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Papakrivopoulou
authors.forename: Samuel
authors.initials: S
authors.lastname: Lillywhite
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001834:Body Water / Q000502:physiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain